0001628280-24-006158 | 10-K | XBRL Viewer

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Income Taxes - Schedule of Components of Deferred Income Tax Assets (Liabilities) (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Deferred Tax Assets
Federal benefit of state taxes payable	$ 263	$ 1,739
Reserves, accruals and other	18,923	31,532
Inventory obsolescence	0	919
Capitalized research and development	17,142	79,946
Stock compensation	9,266	0
Intangible assets	25,214	0
Net operating loss carryforwards	80,184	88,014
Lease liability	14,365	0
Deferred tax assets	165,357	202,150
Deferred Tax Liabilities
Reserves, accruals and other	0	(5,354)
Right-of-use asset	(11,543)	0
Intangible assets	0	(80,770)
Amortization of intangibles other than goodwill	0	(385)
Depreciation	0	(1,469)
Deferred tax liability	(11,543)	(87,978)
Less: valuation allowance	(3,616)	(3,525)
Net deferred tax assets	150,198	110,647
Recorded in the accompanying consolidated balance sheets as:
Noncurrent deferred tax assets, net	$ 150,198	$ 110,647

Stock-Based Compensation - Restricted Stock and TSR (Narrative) (Details) - USD ($)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation expense	$ 13,200,000
Weighted-average remaining period for recognition of unrecognized compensation costs	2 years
Granted (in dollars per share)	$ 74.38
Restricted stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period	3 years
Unrecognized compensation expense	$ 48,400,000
Weighted-average remaining period for recognition of unrecognized compensation costs	2 years
Granted (in dollars per share)	$ 74.38	$ 51.51	$ 20.14
Fair value of vested shares	$ 18,300,000	$ 11,900,000	$ 8,800,000
Total Stockholder Return Restricted Stock Awards
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation expense	$ 26,200,000
Weighted-average remaining period for recognition of unrecognized compensation costs	2 years
Granted (in dollars per share)	$ 127.75	$ 95.31	$ 31.25
Fair value of vested shares	$ 8,200,000	$ 8,800,000	$ 2,000,000
Performance awards, measurement period	3 years
Total Stockholder Return Restricted Stock Awards \| Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting percentages attainable during period	0.00%
Total Stockholder Return Restricted Stock Awards \| Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting percentages attainable during period	200.00%

Description of Business (Details) - USD ($) $ in Thousands	Feb. 20, 2020	Dec. 31, 2023	Dec. 31, 2022
Business Acquisition [Line Items]
Business combination, consideration transferred, equity interests issued (in shares)	26,844,877
Business combination common stock under contingent value right (in shares)	86,630,633
Contingent consideration liabilities		$ 2,700	$ 111,600
Progenics
Business Acquisition [Line Items]
Aggregate cash payments percentage	40.00%
Percentage of total consideration	19.90%
Business combination contingent value right of total consideration	$ 99,600
Progenics \| Cash Payments, 2022
Business Acquisition [Line Items]
Contingent consideration liabilities	100,000
Progenics \| Cash Payments, 2023
Business Acquisition [Line Items]
Contingent consideration liabilities	$ 150,000

Summary of Significant Accounting Policies

12 Months Ended

Dec. 31, 2023

Accounting Policies [Abstract]

Summary of Significant Accounting Policies

Basis of Presentation and Principles of Consolidation

The accompanying consolidated financial statements have been prepared in accordance with U.S. GAAP. The consolidated financial statements include the accounts of the Company and its direct and indirect wholly-owned subsidiaries. All intercompany accounts and transactions have been eliminated in consolidation.

Use of Estimates

The preparation of consolidated financial statements in conformity with U.S. GAAP requires management to make certain estimates and assumptions that affect the reported amounts of assets and liabilities at the date of the consolidated financial statements, and the reported amounts of revenues and expenses during the reporting period. The estimates reflected in the Company’s consolidated financial statements include, but are not limited to, certain judgments regarding revenue recognition, goodwill, tangible and intangible asset valuation, inventory valuation, asset retirement obligations, contingent assets and liabilities, income tax liabilities and related indemnification receivable, deferred tax assets and liabilities and accrued expenses. Actual results could materially differ from those estimates or assumptions.

Revenue Recognition

The Company recognizes revenue when it transfers control of promised goods or services to its customers in an amount that reflects the consideration to which the Company expects to be entitled to in exchange for those goods and services. See Note 3, “Revenue from Contracts with Customers” for further discussion on revenues.

Accounts Receivable, net

Accounts receivable consist of amounts billed and currently due from customers. The Company maintains an allowance for doubtful accounts for estimated losses. In determining the allowance, consideration includes the probability of recoverability based on past experience and general economic factors. Certain accounts receivable may be fully reserved when the Company becomes aware of any specific collection issues. The Company periodically reviews the aging of receivables, payment history and customer creditworthiness to determine if adjustments to the allowance for doubtful accounts is necessary. Allowance for doubtful accounts has been immaterial for all years presented.

Income Taxes

The Company accounts for income taxes using an asset and liability approach. Income tax (benefit) expense represents income taxes paid or payable for the current year plus the change in deferred taxes during the year. Deferred taxes result from differences between the financial and tax bases of the Company’s assets and liabilities. Deferred tax assets and liabilities are measured using the currently enacted tax rates that apply to taxable income in effect for the years in which those tax attributes are expected to be recovered or paid, and are adjusted for changes in tax rates and tax laws when such changes are enacted.

The Company recognizes deferred tax assets to the extent that the Company believes that these assets are more-likely-than-not to be realized. Valuation allowances are recorded to reduce deferred tax assets when it is more-likely-than-not that the future tax benefit will not be realized. The assessment of whether or not a valuation allowance is required involves weighing both positive and negative evidence, including both historical and prospective information, with greater weight given to evidence that is objectively verifiable. A history of recent losses is negative evidence that is difficult to overcome with positive evidence. In evaluating prospective information there are four sources of taxable income: reversals of taxable temporary differences, items that can be carried back to prior tax years (such as net operating losses), pre-tax income, and prudent and feasible tax planning strategies. Adjustments to the deferred tax valuation allowances are made in the period when those assessments are made.

The Company accounts for uncertain tax positions using a two-step recognition threshold and measurement analysis method to determine the financial statement impact of uncertain tax positions taken or expected to be taken in a tax return. Differences between tax positions taken in a tax return and amounts recognized in the financial statements are recorded as adjustments to other long-term assets and liabilities, or adjustments to deferred taxes, or both. The Company records the related interest and penalties to income tax (benefit) expense.

Net Income (Loss) per Common Share

The Company computes earnings per share using the two-class method. Basic earnings per common share is computed by dividing net income by the weighted-average number of shares of common stock outstanding during the period. Diluted earnings per common share is computed by dividing net income by the weighted-average number of shares of common stock outstanding during the period, plus the potential dilutive effect of other securities as if those securities were converted or exercised. The Company’s potentially dilutive shares, which could include shares issuable upon conversion of the 2.625% Convertible Senior Notes due 2027 (the “Notes”), are considered to be common stock equivalents and are only included in the calculation of diluted net income per share when their effect is dilutive. The Company has the option to settle the Notes through cash settlement or a combination of cash and share settlement provided that the principal is settled in cash and the conversion spread is settled in cash or shares as elected by the Company. The Company applies the if-converted method for diluted earnings in order to reflect the conversion spread. During periods in which the Company incurs net losses, both basic and diluted loss per common share is calculated by dividing the net loss by the weighted-average shares of common stock outstanding and potentially dilutive securities are excluded from the calculation because their effect would be antidilutive.

Cash and Cash Equivalents

Cash and cash equivalents include savings deposits, certificates of deposit and money market funds that have original maturities of three months or less when purchased.

Restricted Cash

Restricted cash as of December 31, 2023 and 2022, represents primarily collateral for a letter of credit securing a lease obligation and a security deposit. The Company believes the carrying value of these assets approximates fair value.

Concentration of Risks and Limited Suppliers

Financial instruments which potentially subject the Company to concentrations of credit risk consist principally of trade accounts receivable. The Company periodically reviews its accounts receivable for collectability and provides for an allowance for doubtful accounts to the extent that amounts are not expected to be collected. The Company sells primarily to hospitals, independent diagnostic testing facilities, and radiopharmacies.

As of December 31, 2023 and 2022, no customer accounted for greater than 10% of accounts receivable, net. No customer accounted for greater than 10% of revenues for the years ended December 31, 2023, 2022 and 2021.

The Company relies on certain materials used in its development and manufacturing processes, some of which are procured from only one or a few sources. The failure of one of these suppliers to deliver on schedule could delay or interrupt the manufacturing or commercialization process and would adversely affect the Company’s operating results. In addition, a disruption in the commercial supply of, or a significant increase in the cost of one of the Company’s materials from these sources could have a material adverse effect on the Company’s business, financial position and results of operations.

The Company currently relies on JHS as its significant manufacturer of DEFINITY and its sole source manufacturer of NEUROLITE, CARDIOLITE and evacuation vials for TechneLite. The Company relies on Samsung Biologics Co., Ltd. (“SBL”) as its sole source manufacturer of DEFINITY RT. The Company has Mo-99 supply agreements with IRE of Belgium, running through December 31, 2024, with auto-renewal provisions and terminable upon notice of non-renewal, and with NTP and its subcontractor ANSTO, running through December 31, 2024.

The following table sets forth revenues for each of the Company’s products representing 10% or more of revenues:


	Year Ended December 31,
	2023		2022		2021
PYLARIFY	65.7	%	56.4	%	10.2	%
DEFINITY	21.6	%	26.2	%	54.7	%
TechneLite	6.7	%	9.5	%	21.5	%

Inventory

Inventory includes material, direct labor and related manufacturing overhead and is stated at the lower of cost and net realizable value on a first-in, first-out basis. The Company records inventory when the Company takes title to the product.

The Company assesses the recoverability of inventory to determine whether adjustments for excess and obsolete inventory are required. Inventory that is in excess of future requirements is written down to its estimated net realizable value based on product shelf life, forecasted demand and other factors.

Inventory costs associated with product that has not yet received regulatory approval are capitalized if the Company believes there is probable future commercial use of the product and future economic benefits of the asset. If future commercial use of the product is not probable, then inventory costs associated with such product are expensed as incurred. The Company had no inventory pending regulatory approval as of December 31, 2023.

Property, Plant and Equipment, net

Property, plant & equipment are stated at cost. Replacements of major units of property are capitalized, and replaced properties are retired. Replacements of minor components of property and repair and maintenance costs are charged to expense as incurred. Certain costs to obtain or develop computer software are capitalized and amortized over the estimated useful life of the software. Depreciation and amortization are computed on a straight-line basis over the estimated useful lives of the related assets and recorded

in costs of goods sold and operating expenses in the associated functional expense category which utilizes the associated asset. The estimated useful lives of the major classes of depreciable assets are as follows:


Class						Range of Estimated Useful Lives
Buildings						10 - 50 years
Land improvements						15 - 40 years
Machinery and equipment						3 - 15 years
Furniture and fixtures						15 years
Leasehold improvements						Lesser of lease term or 15 years
Computer software						3 - 5 years

Upon retirement or other disposal of property, plant & equipment, the cost and related amount of accumulated depreciation are removed from the asset and accumulated depreciation accounts, respectively. The difference, if any, between the net asset value and the proceeds is included in operating income.

Included within machinery and equipment are spare parts. Spare parts include replacement parts relating to plant & equipment and are either recognized as an expense when consumed or reclassified and capitalized as part of the related asset and depreciated over the remaining useful life of the related asset.

Business Combinations

The Company accounts for business combinations using the acquisition method of accounting. The Company recognizes the assets acquired and liabilities assumed in business combinations on the basis of their fair values at the date of acquisition. The Company assesses the fair value of assets acquired, including intangible assets, and liabilities assumed using a variety of methods. Each asset acquired and liability assumed is measured at fair value from the perspective of a market participant. The method used to estimate the fair values of intangible assets incorporates significant assumptions regarding the estimates a market participant would make in order to evaluate an asset, including a market participant’s use of the asset and the appropriate discount rates. Acquired IPR&D is recognized at fair value and initially characterized as an indefinite-lived intangible asset, irrespective of whether the acquired IPR&D has an alternative future use. Any excess purchase price over the fair value of the net tangible and intangible assets acquired is allocated to goodwill. Transaction costs and restructuring costs associated with a business combination are expensed as incurred.

During the measurement period, which extends no later than one year from the acquisition date, the Company may record certain adjustments to the carrying value of the assets acquired and liabilities assumed with the corresponding offset to goodwill. After the measurement period, all adjustments are recorded in the consolidated statements of operations as operating expenses or income. The Company recorded a measurement period adjustment of $2.6 million related to deferred taxes for the three months ended March 31, 2021, which finalized all measurement period adjustments related to the Progenics Acquisition.

Goodwill

Goodwill is not amortized but is instead tested for impairment at least annually and whenever events or circumstances indicate that it is more likely-than-not that it may be impaired. The Company has elected to perform the annual test for goodwill impairment as of October 31 of each year.

In performing the Company’s annual assessment, the Company is permitted to first perform a qualitative test and if necessary, perform a quantitative test. If the Company is required to perform the quantitative impairment test of goodwill, the Company compares the fair value of a reporting unit to its carrying value. If the reporting unit’s carrying value exceeds its fair value, the Company would record an impairment loss to the extent that the carrying value of goodwill exceeds its implied fair value. The Company estimates the fair value of its reporting units using discounted cash flow or other valuation models, such as comparative transactions and market multiples. The Company performed a qualitative assessment and did not recognize any goodwill impairment charges during the years ended December 31, 2023, 2022 or 2021.

Intangible and Long-Lived Assets

The Company tests intangible and long-lived assets for recoverability whenever events or changes in circumstances suggest that the carrying value of an asset or group of assets may not be recoverable. The Company measures the recoverability of assets to be held and used by comparing the carrying amount of the asset to future undiscounted net cash flows expected to be generated by the asset. If those assets are considered to be impaired, the impairment equals the amount by which the carrying amount of the assets exceeds the fair value of the assets. Any impairments are recorded as permanent reductions in the carrying amount of the assets. See Note 7, “Property, Plant and Equipment, Net” for further details on impairment. Long-lived assets, other than goodwill and other intangible assets that are held for sale are recorded at the lower of the carrying value or the fair market value less the estimated cost to sell.

Intangible assets, consisting of patents, trademarks, customer relationships, a currently marketed product, licenses and developed technology related to the Company’s products are amortized in a method equivalent to the estimated utilization of the economic benefit of the asset.

Costs of IPR&D intangible assets acquired as part of an asset acquisition that have no alternative future use are expensed when incurred. Milestone payments made after regulatory approval are capitalized as an intangible asset and amortized over an estimated useful life of the product. Cash payments related to acquired IPR&D intangible assets are reflected as an investing cash flow in the Company's consolidated statement of cash flows.

The Company’s IPR&D intangible assets includes intangible assets acquired in a business combination that are used in research and development activities but have not yet reached technological feasibility, regardless of whether they have alternative future use. The primary basis for determining the technological feasibility or completion of these projects is obtaining regulatory approval to market the underlying products in an applicable geographic region. Because obtaining regulatory approval can include significant risks and uncertainties, the eventual realized value of the acquired IPR&D projects may vary from their fair value at the date of acquisition. The Company classifies IPR&D intangible assets acquired in a business combination as an indefinite-lived intangible asset until the completion or abandonment of the associated research and development efforts. Upon completion of the associated research and development efforts, the Company will determine the useful life and begin amortizing the assets to reflect their use over their remaining lives. Upon permanent abandonment, the Company writes-off the remaining carrying amount of the associated IPR&D intangible asset. IPR&D intangible assets are tested at least annually as of October 31 or when a triggering event occurs that could indicate a potential impairment and any impairment loss is recognized in the Company’s consolidated statements of operations. See Note 10, “Intangibles, net and Goodwill” for further details on impairment.

Contingencies

In the normal course of business, the Company is subject to loss contingencies, such as legal proceedings and claims arising out of its business, that cover a wide range of matters, including, among others, product and environmental liability. The Company records accruals for those loss contingencies when it is probable that a liability will be incurred and the amount of loss can be reasonably estimated. The Company does not recognize gain contingencies until realized.

Convertible Notes

The Company evaluates convertible notes to determine if those contracts or embedded components of those contracts qualify as derivatives to be separately accounted for. The change in fair value of any separately recognized derivative is recorded in the consolidated statement of operations as other income or expense. Upon conversion, exercise or cancellation of a derivative instrument, the instrument is marked to fair value at the date of conversion, exercise or cancellation.

Fair Values of Financial Instruments

The estimated fair values of the Company’s financial instruments, including its cash and cash equivalents, accounts receivable, accounts payable and accrued expenses approximate the carrying values of these instruments due to their short term nature. The Company’s long-term debt has triggering events that would impact the fair value of the instruments. The Company determined that no triggering event has occurred during the years ended December 31, 2023 and December 31, 2022. As of December 31, 2023, the fair value of the Company’s convertible debt was estimated to be approximately $644.3 million based on external pricing data, including quoted market prices of these instruments and was classified as a Level 1 measurement within the fair value hierarchy. As of December 31, 2022, the carrying value of the Company’s convertible debt approximated fair value and was classified as a Level 1 measurement within the fair value hierarchy. The fair value See Note 4, “Fair Value of Financial Instruments”.

Contingent Consideration Liabilities

The estimated fair value of contingent consideration liabilities are initially measured and recorded on the acquisition date, are considered to be a Level 3 instrument and are reviewed quarterly, or whenever events or circumstances occur that indicate a change in fair value. The contingent consideration liabilities are recorded at fair value at the end of each reporting period with changes in estimated fair values recorded in general and administrative expenses in the consolidated statements of operations.

The estimated fair value is determined based on probability adjusted discounted cash flows and Monte Carlo simulation models that include significant estimates and assumptions pertaining to commercialization events and sales targets. The most significant unobservable inputs are the probabilities of achieving regulatory approval of the development projects and subsequent commercial success.

Significant changes in any of the probabilities of success would result in a significantly higher or lower fair value measurement. Significant changes in the probabilities as to the periods in which milestones will be achieved would result in a significantly lower or higher fair value measurement.

The Company's acquisitions accounted for as asset acquisitions may also include contingent consideration payments to be made for sales-based milestones, development and regulatory milestones. The Company assesses whether such contingent consideration meets the definition of a derivative. Contingent consideration payments in an asset acquisition not required to be accounted for as derivatives are recognized when the contingency is resolved, and the consideration is paid or becomes payable. Contingent consideration payments required to be accounted for as derivatives are recorded at fair value on the date of the acquisition and are subsequently remeasured to fair value at each reporting date. Upon recognition of the contingent consideration payment, the amount is included in the cost of the acquired asset or group of assets.

Derivative Instruments

The Company has used interest rate swaps to reduce the variability in cash flows associated with a portion of the Company’s forecasted interest payments on its variable rate debt. To qualify for hedge accounting, the hedging instrument must be highly effective at reducing the risk from the exposure being hedged. Further, the Company must formally document the hedging relationship at inception and, on at least a quarterly basis, continually reevaluate the relationship to ensure it remains highly effective throughout the life of the hedge. The Company does not enter into derivative financial instruments for speculative or trading purposes.

Advertising and Promotion Costs

Advertising and promotion costs are expensed as incurred. During the years ended December 31, 2023, 2022 and 2021, the Company incurred $26.0 million, $26.0 million and $17.5 million, respectively in advertising and promotion costs, which are included in sales and marketing in the consolidated statements of operations.

Research and Development

Research and development costs are expensed as incurred and relate primarily to the development of new products to add to the Company’s portfolio and costs related to its medical affairs and medical information functions. Nonrefundable advance payments for goods or services that will be used or rendered for future research and development activities are deferred and recognized as an expense as the goods are delivered or the related services are performed.

Foreign Currency

The consolidated statements of operations of the Company’s foreign subsidiaries are translated into U.S. Dollars using weighted-average exchange rates. The net assets of the Company’s foreign subsidiaries are translated into U.S. Dollars using the end of period exchange rates. The impact from translating the net assets of these subsidiaries at changing rates are recorded in the foreign currency translation adjustment account, which is included in accumulated other comprehensive loss in the consolidated balance sheets.

Remeasurement of the Company’s foreign currency denominated transactions are included in net income. Transaction gains and losses are reported as a component of other loss (income) in the consolidated statements of operations.

Stock-Based Compensation

The Company’s stock-based compensation cost is measured at the grant date of the stock-based award based on the fair value of the award and is recognized as expense over the requisite service period, which generally represents the vesting period, and includes an estimate of the awards that will be forfeited. The Company estimates the fair value of each stock-based award on its measurement date using either the current market price of the stock, the Black-Scholes option valuation model or the Monte Carlo simulation valuation model, whichever is most appropriate. The Black-Scholes and Monte Carlo simulation valuation models incorporate assumptions such as stock price volatility, the expected life of options or awards, a risk-free interest rate and dividend yield.

Expected volatility is based on the historical volatility of the Company’s stock price. The risk-free interest rates are based on quoted U.S. Treasury rates for securities with maturities approximating the awards’ expected lives. Expected lives are principally based on the Company’s historical exercise experience with previously issued awards. The expected dividend yield is zero as the Company has never paid dividends and does not currently anticipate paying any in the foreseeable future.

Expense for performance restricted stock awards is recognized based upon the fair value of the awards on the date of grant and the number of shares expected to vest based on the terms of the underlying award agreement and the requisite service period(s).

Other Loss (Income)

Other loss (income) consisted of the following:


	Year Ended December 31,
(in thousands)	2023		2022		2021
Foreign currency losses	$	21	$	256	$	274
Tax indemnification expense, net	4,943		9,554		7,121
Interest income	(19,638)		(2,613)		(45)
Interest rate swap termination	—		(5,494)		—
Gain on sale of RELISTOR licensed intangible asset associated with net sales royalties	(51,789)
Other	143		—		—
Total other (income) loss	$	(66,320)	$	1,703	$	7,350

Comprehensive Income (Loss)

Comprehensive income (loss) consists of net income (loss) and other gains and losses affecting stockholders’ equity that, under U.S. GAAP, are excluded from net income. For the Company, other comprehensive income (loss) consists of foreign currency translation gains and losses as well as realized and unrealized gains and losses on cash flow hedges related to the Company’s interest rate swaps. The accumulated other comprehensive income (loss) balance consists entirely of foreign currency translation gains and losses and realized and unrealized gains and losses on outstanding cash flow hedges related to the Company’s interest rate swaps.

Asset Retirement Obligations

The Company’s compliance with federal, state, local and foreign environmental laws and regulations may require it to remove or mitigate the effects of the disposal or release of chemical substances in jurisdictions where it does business or maintains properties. The Company establishes accruals when those costs are legally obligated and can be reasonably estimated. Accrual amounts are estimated, which may include the assistance of third-party environmental specialists, and are based on currently available information, regulatory requirements, remediation strategies, historical experience, the relative shares of the total remediation costs, a relevant discount rate, and the time periods of when estimated costs can be reasonably predicted. Changes in these assumptions could impact the Company’s future reported results.

The Company has production facilities which manufacture and process radioactive materials at its North Billerica, Massachusetts campus and its Somerset, New Jersey site. The Company considers its legal obligation to remediate its facilities upon a decommissioning of its radioactive-related operations as an asset retirement obligation. The fair value of a liability for asset retirement obligations is recognized in the period in which the liability is incurred. The liability is measured at the present value of the obligation expected to be incurred and is adjusted in subsequent periods as accretion expense is recorded. The corresponding asset retirement costs are capitalized as part of the carrying values of the related long-lived assets and depreciated over the assets’ useful lives.

The Company has identified conditional asset retirement obligations related to the future removal and disposal of asbestos contained in certain of the buildings located on the Company’s North Billerica, Massachusetts campus. The Company believes the asbestos is appropriately contained and it is compliant with all applicable environmental regulations. If these properties undergo major renovations or are demolished, certain environmental regulations are in place, which specify the manner in which asbestos must be handled and disposed. The Company is required to record the fair value of these conditional liabilities if they can be reasonably estimated. As of December 31, 2023 and 2022, sufficient information was not available to estimate a liability for such conditional asset retirement obligations as the obligations to remove the asbestos from these properties have indeterminable settlement dates. As such, no liability for conditional asset retirement obligations has been recorded in the accompanying consolidated balance sheets as of December 31, 2023 and 2022.

Self-Insurance Reserves

The Company’s consolidated balance sheets at December 31, 2023 and 2022 include $1.0 million and $0.9 million of accrued liabilities associated with employee medical costs that are retained by the Company, respectively. The Company estimates the required liability of those claims on an undiscounted basis based upon various assumptions which include, but are not limited to, the Company’s historical loss experience and projected loss development factors. The required liability is also subject to adjustment in the future based upon changes in claims experience, including changes in the number of incidents (frequency) and change in the ultimate cost per incident (severity).

Recent Accounting Pronouncements

In December 2023, the FASB issued ASU 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures, which requires all public entities, including public entities with a single reportable segment, to provide in interim and annual periods one or more measures of segment profit or loss used by the chief operating decision maker to allocate resources and assess performance. Additionally, the standard requires disclosures of significant segment expenses and other segment items as well as incremental qualitative disclosures. The guidance in this update is effective for fiscal years beginning after December 15, 2023, and interim periods after December 15, 2024. The Company is currently in the process of evaluating the effects of this pronouncement on our related disclosures.

In December 2023, the FASB also issued ASU 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures, which requires enhanced income tax disclosures, including specific categories and disaggregation of information in the effective tax rate reconciliation, disaggregated information related to income taxes paid, income or loss from continuing operations before income tax expense or benefit, and income tax expense or benefit from continuing operations. The requirements of the ASU are effective for annual periods beginning after December 15, 2024, with early adoption permitted. The Company is currently in the process of evaluating the impact of this pronouncement on our related disclosures.

Leases (Tables)

12 Months Ended

Dec. 31, 2023

Leases [Abstract]

Schedule of Operating and Finance Lease Assets and Liabilities

Operating and finance lease assets and liabilities are as follows:


(in thousands)	Classification	December 31, 2023		December 31, 2022
Assets
Operating	Other long-term assets	$	45,325	$	19,033
Finance	Property, plant and equipment, net	1,438		582
Total leased assets		$	46,763	$	19,615
Liabilities
Current
Operating	Accrued expenses and other liabilities	$	1,904	$	2,177
Finance	Current portion of long-term debt and other borrowings	823		354
Noncurrent
Operating	Other long-term liabilities	54,453		25,442
Finance	Long-term debt, net and other borrowings	625		231
Total leased liabilities		$	57,805	$	28,204

Schedule of Components of Lease Expense and Other Information

The components of lease expense were as follows:


(in thousands)	Year Ended December 31, 2023		Year Ended December 31, 2022
Operating lease expense	$	4,627	$	1,797
Finance lease expense
Amortization of ROU assets	795		426
Interest on lease liabilities	81		28

Total lease expense	$	5,503	$	2,251

Other information related to leases were as follows:


		December 31, 2023		December 31, 2022
Weighted-average remaining lease term (Years):
Operating leases		13.5		7.9
Finance leases		2.3		1.9
Weighted-average discount rate:
Operating leases		7.3%		4.8%
Finance leases		6.2%		4.4%

(in thousands)		Year Ended December 31, 2023		Year Ended December 31, 2022
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$	3,462	$	2,440
Operating cash flows from finance leases		81		28
Financing cash flows from finance leases		504		384
ROU assets obtained in exchange for lease obligations:
Operating leases		29,396		11,019
Finance leases		1,437		582

Schedule of Future Minimum Lease Payments Under Operating Leases

Future minimum lease payments under non-cancellable leases as of December 31, 2023 were as follows:


(in thousands)	Operating Leases		Finance Leases
2024	$	4,624	$	846
2025	5,413		664
2026	7,090		151
2027	7,312		—
2028	7,453		—
Thereafter	67,642		—
Total future minimum lease payments	99,534		1,661
Less: interest	43,177		213
Total	$	56,357	$	1,448

Schedule of Future Minimum Lease Payments Under Finance Leases

Future minimum lease payments under non-cancellable leases as of December 31, 2023 were as follows:


(in thousands)	Operating Leases		Finance Leases
2024	$	4,624	$	846
2025	5,413		664
2026	7,090		151
2027	7,312		—
2028	7,453		—
Thereafter	67,642		—
Total future minimum lease payments	99,534		1,661
Less: interest	43,177		213
Total	$	56,357	$	1,448

Stock-Based Compensation - Schedule of TSR Award Activity (Details) - $ / shares	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Shares
Nonvested beginning balance (in shares)	1,249,992
Granted (in shares)	710,985
Vested (in shares)	(612,912)
Forfeited (in shares)	(137,806)
Nonvested ending balance (in shares)	1,210,259	1,249,992
Weighted- Average Grant Date Fair Value Per Share
Nonvested beginning balance (in dollars per share)	$ 34.65
Granted (in dollars per share)	74.38
Vested (in dollars per share)	29.78
Forfeited (in dollars per share)	50.36
Nonvested, ending balance (in dollars per share)	$ 58.71	$ 34.65
Total Stockholder Return Restricted Stock Awards
Shares
Nonvested beginning balance (in shares)	658,875
Granted (in shares)	365,478
Vested (in shares)	(348,302)
Forfeited (in shares)	(45,997)
Nonvested ending balance (in shares)	630,054	658,875
Weighted- Average Grant Date Fair Value Per Share
Nonvested beginning balance (in dollars per share)	$ 48.58
Granted (in dollars per share)	127.75	$ 95.31	$ 31.25
Vested (in dollars per share)	23.43
Forfeited (in dollars per share)	57.77
Nonvested, ending balance (in dollars per share)	$ 78.91	$ 48.58

Accumulated Other Comprehensive Loss (Details) - USD ($)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Accumulated Other Comprehensive Income (Loss) [Line Items]
Accumulated other comprehensive loss, tax	$ 0	$ 0
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Beginning balance	447,147,000	464,439,000
Other comprehensive income (loss) before reclassifications	222,000	5,333,000
Amounts reclassified to earnings		(6,107,000)
Ending balance	815,892,000	447,147,000
Accumulated other comprehensive loss
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Beginning balance	(1,259,000)	(485,000)
Ending balance	(1,037,000)	(1,259,000)
Foreign currency translation
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Beginning balance	(1,259,000)	(754,000)
Other comprehensive income (loss) before reclassifications	222,000	(505,000)
Amounts reclassified to earnings		0
Ending balance	(1,037,000)	(1,259,000)
Unrealized loss on cash flow hedges
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Beginning balance	0	269,000
Other comprehensive income (loss) before reclassifications	0	5,838,000
Amounts reclassified to earnings		(6,107,000)
Ending balance	$ 0	$ 0

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References + Details

- Definition

Amount of equity (deficit) attributable to parent. Excludes temporary equity and equity attributable to noncontrolling interest.

+ References

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+ Details

Net Income (Loss) Per Common Share (Tables)

12 Months Ended

Dec. 31, 2023

Earnings Per Share [Abstract]

Schedule of Net Income (loss) Per Common Share

A summary of net income (loss) per common share is presented below:


	Year Ended December 31,
(in thousands, except per share amounts)	2023		2022		2021
Net income (loss)	$	326,661	$	28,067	$	(71,279)

Basic weighted-average common shares outstanding	68,266		68,487		67,486
Effect of dilutive stock options	346		439		—

Effect of dilutive restricted stock	1,428		1,745		—
Effect of convertible debt instrument	199		—		—
Diluted weighted-average common shares outstanding	70,239		70,671		67,486

Basic income (loss) per common share	$	4.79	$	0.41	$	(1.06)
Diluted income (loss) per common share	$	4.65	$	0.40	$	(1.06)

Antidilutive securities excluded from diluted net income (loss) per common share	421		358		2,893

Intangibles, Net and Goodwill - Schedule of Expected Future Amortization Expense Related to Intangible Assets (Details) $ in Thousands	Dec. 31, 2023 USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
2024	$ 39,726
2025	24,409
2026	25,206
2027	19,680
2028	16,195
2029 and thereafter	26,769
Total	$ 151,985

Stock-Based Compensation - Valuation Model Assumptions (Details) - Options - USD ($)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected volatility	56.10%	62.10%	0.00%
Risk-free interest rate	4.00%	2.00%	0.00%
Expected life (in years)	6 years	6 years
Expected dividend yield	$ 0	$ 0	$ 0

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

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+ Details

Income Taxes - Schedule of Components of Income Before Income Taxes (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Tax Disclosure [Abstract]
U.S.	$ 410,326	$ 29,012	$ (76,389)
International	617	(2,293)	1,351
Income (loss) before income taxes	$ 410,943	$ 26,719	$ (75,038)

- Definition

Amount of income (loss) from continuing operations, including income (loss) from equity method investments, before deduction of income tax expense (benefit), and income (loss) attributable to noncontrolling interest.

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+ Details

Stock-Based Compensation

12 Months Ended

Dec. 31, 2023

Share-Based Payment Arrangement [Abstract]

Stock-Based Compensation

Equity Incentive Plans

As of December 31, 2023, the Company’s approved equity incentive plans included the 2015 Equity Incentive Plan (“2015 Plan”), the 2013 Equity Incentive Plan (“2013 Plan”), and the 2008 Equity Incentive Plan (“2008 Plan”). These plans are administered by the Board of Directors and permit the granting of stock options, stock appreciation rights, restricted stock, restricted stock units and dividend equivalent rights to employees, officers, directors and consultants of the Company.

The Company has certain stock option and restricted stock awards outstanding under each of its equity incentive plans but, upon adoption of the 2015 Plan, no longer grants new equity awards under its 2008 and 2013 Plans. The Company adopted its 2015 Plan in June 2015 and subsequently amended the plan in April 2016, 2017, 2019, 2021 and 2022 which increased the common stock reserved for issuance under the plan to an aggregate 10,930,277 shares. The Company assumed Progenics equity plans due to the acquisition as discussed in Note 1, “Description of Business”. The Company no longer grants new equity awards under the Progenics equity plans.

Stock-based compensation expense recognized in the consolidated statements of operations is summarized below:


	Year Ended December 31,
(in thousands)	2023		2022		2021
Cost of goods sold	$	9,126	$	4,422	$	2,370
Sales and marketing	9,500		6,185		2,472
General and administrative	24,807		14,876		9,092
Research and development	7,074		3,779		2,000
Total stock-based compensation expense	$	50,507	$	29,262	$	15,934

Stock Options

Stock option awards under the 2015 Plan are granted with an exercise price equal to the fair value of the Company’s common stock at the date of grant. All option awards have a ten-year contractual term.

A summary of option activity for 2023 is presented below:


	Total Stock Options	Weighted- Average Exercise Price		Weighted- Average Remaining Contractual Term (Years)	Aggregate Intrinsic Value
Balance at January 1, 2023	874,749	$	30.37	5.8	19,058,224
Options granted	332,368	$	76.41
Options exercised	(214,619)	$	19.02
Options cancelled and forfeited	(35,326)	$	51.30
Outstanding at December 31, 2023	957,172	$	48.13	6.7	18,283,464
Vested and expected to vest at December 31, 2023	957,172	$	48.13	6.7	18,283,464
Exercisable at December 31, 2023	466,039	$	26.99	4.4	16,462,767

The table below summarizes the key weighted-average assumptions used in valuing stock options granted:


	Year Ended December 31,
	2023		2022		2021
Expected volatility	56.1	%	62.1	%	—	%
Risk-free interest rate	4.0	%	2.0	%	—	%
Expected life (in years)	6.0		6.0		—
Expected dividend yield	—		—		—

During the years ended December 31, 2023, 2022 and 2021, 214,619, 397,822 and 318,662 options were exercised having aggregate intrinsic values of $12.9 million, $13.1 million and $1.6 million, respectively.

As of December 31, 2023, there was $13.2 million of unrecognized compensation expense related to outstanding stock options, which is expected to be recognized over a weighted-average period of 2.0 years.

Restricted Stock

A summary of restricted stock awards and restricted stock units activity for 2023 is presented below:


	Shares	Weighted- Average Grant Date Fair Value Per Share
Nonvested balance at January 1, 2023	1,249,992	$	34.65
Granted	710,985	$	74.38
Vested	(612,912)	$	29.78
Forfeited	(137,806)	$	50.36
Nonvested balance at December 31, 2023	1,210,259	$	58.71

Restricted stock generally vest over 3 years. As of December 31, 2023, there was $48.4 million of unrecognized compensation expense related to outstanding restricted stock, which is expected to be recognized over a weighted-average period of 2.0 years.

The weighted average grant-date fair value for restricted stock granted during the fiscal years ended December 31, 2023, 2022 and 2021 was $74.38, $51.51 and $20.14 per share, respectively. The total fair value of restricted stock vested in fiscal years 2023, 2022 and 2021 was $18.3 million, $11.9 million and $8.8 million, respectively.

Total Stockholder Return Restricted Stock Awards (“TSR Awards”)

During the years ended December 31, 2023, 2022 and 2021, the Company granted total stockholder return (“TSR”) Awards that include a three-year market condition where the performance measurement period is three years. Vesting of the TSR Awards is based on the Company’s level of attainment of specified TSR targets relative to the percentage appreciation of a specified index of companies for the respective three-year period and is also subject to the continued employment of the grantees. The number of shares that are earned over the performance period ranges from 0% to 200% of the initial award. The fair value of these awards are based on a Monte Carlo simulation valuation model with the following assumptions:


	Year Ended December 31,
	2023		2022		2021
Expected volatility	52.8	%	56.6	%	54.0	%
Risk-free interest rate	4.6	%	1.7	%	30.0	%
Expected life (in years)	2.8		2.8		2.8
Expected dividend yield	—		—		—

A summary of TSR Award activity for 2023 is presented below:


	Shares	Weighted- Average Grant Date Fair Value Per Share
Nonvested balance at January 1, 2023	658,875	$	48.58
Granted	365,478	$	127.75
Vested	(348,302)	$	23.43
Forfeited	(45,997)	$	57.77
Nonvested balance at December 31, 2023	630,054	$	78.91

As of December 31, 2023, there was $26.2 million of unrecognized compensation expense related to outstanding performance restricted stock which is expected to be recognized over a weighted-average period of 2.0 years.

The weighted average grant-date fair value for TSR Awards granted during the fiscal years ended December 31, 2023, 2022 and 2021 was $127.75, $95.31 and $31.25 per share, respectively. The total fair value of TSR Awards vested in fiscal years 2023, 2022 and 2021 was $8.2 million, $8.8 million and $2.0 million, respectively.

Common Stock Repurchases

In December 2022, the Company’s Board of Directors authorized the repurchase of up to $150.0 million in aggregate amount of the Company’s common stock under certain circumstances. The Company used approximately $75.0 million of the net proceeds from the Notes to repurchase shares of their common stock from purchasers of the Notes in privately negotiated transactions effected with or through one of the initial purchasers or its affiliate. The purchase price per share of the common stock repurchased in such transactions was equal to the closing sale price per share of the Company’s common stock on the date of the offering memorandum used for the Notes, which was $56.01 per share. Following this initial repurchase, the Company may from time to time repurchase additional shares of their common stock. In the year ended December 31, 2022, the Company purchased approximately 1.3 million shares of their outstanding common stock for $75.0 million as part of the program. The Company did not purchase any shares of its outstanding common stock in the year ended December 31, 2023.

Summary of Significant Accounting Policies - Self-Insurance Reserves (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Accounting Policies [Abstract]
Accrued liabilities associated with employee medical costs	$ 1.0	$ 0.9

Fair Value of Financial Instruments - Schedule of Financial Instruments With Significant Level 3 Inputs (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Financial Assets
Fair value, beginning of period	$ 0	$ 9,300
Changes in fair value included in net income (loss)	0	(9,300)
Cash Payments	0	0
Fair value, end of period	0	0
Financial Liabilities
Fair value, beginning of period	111,600	86,200
Changes in fair value included in net income (loss)	(9,275)	25,400
Cash Payments	(99,625)	0
Fair value, end of period	$ 2,700	$ 111,600
Fair Value, Liability, Recurring Basis, Unobservable Input Reconciliation, Gain (Loss), Statement of Income or Comprehensive Income [Extensible Enumeration]	General and administrative
Fair Value, Asset, Recurring Basis, Unobservable Input Reconciliation, Gain (Loss), Statement of Income or Comprehensive Income [Extensible Enumeration]	General and administrative

Stock-Based Compensation - Schedule of Stock Options (Details) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Share-Based Payment Arrangement [Abstract]
Contractual term	10 years
Total Stock Options
Options outstanding, beginning balance (in shares)	874,749
Options granted (in shares)	332,368
Options exercised (in shares)	(214,619)	(397,822)	(318,662)
Options cancelled and forfeited (in shares)	(35,326)
Options outstanding, ending balance (in shares)	957,172	874,749
Exercisable (in shares)	466,039
Weighted- Average Exercise Price
Options outstanding, beginning balance (in dollars per share)	$ 30.37
Options granted (in dollars per share)	76.41
Options exercised (in dollars per share)	19.02
Options cancelled and forfeited (in dollars per share)	51.30
Options outstanding, ending balance (in dollars per share)	48.13	$ 30.37
Exercisable (in dollars per share)	$ 26.99
Weighted- Average Remaining Contractual Term (Years)
Options outstanding, weighted average remaining contractual term (in years)	6 years 8 months 12 days	5 years 9 months 18 days
Exercisable, weighted average remaining contractual term (in years)	4 years 4 months 24 days
Options outstanding, aggregate intrinsic value	$ 18,283,464	$ 19,058,224
Exercisable, aggregate intrinsic value	$ 16,462,767

Summary of Significant Accounting Policies - Schedule of Product Concentration Risk (Details) - Revenue Benchmark - Product Concentration Risk	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
PYLARIFY
Concentration Risk [Line Items]
Concentration risk percentage	65.70%	56.40%	10.20%
DEFINITY
Concentration Risk [Line Items]
Concentration risk percentage	21.60%	26.20%	54.70%
TechneLite
Concentration Risk [Line Items]
Concentration risk percentage	6.70%	9.50%	21.50%

Audit Information	12 Months Ended
Audit Information	Dec. 31, 2023
Audit Information [Abstract]
Auditor Firm ID	34
Auditor Location	Boston, Massachusetts
Auditor Name	Deloitte & Touche LLP

Revenue from Contracts with Customers - Narrative (Details) $ in Thousands	3 Months Ended		12 Months Ended
	Dec. 31, 2023 USD ($)	Mar. 31, 2022 USD ($)	Dec. 31, 2023 USD ($) productCategory	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)
Disaggregation of Revenue [Line Items]
Number of product categories \| productCategory			3
Revenues			$ 1,296,429	$ 935,061	$ 425,208
Total amount awarded		$ 24,000
Payment terms			standard payment terms are 30 to 60 days
License and Royalty Revenues, Sales-Based Milestone Payment
Disaggregation of Revenue [Line Items]
Revenues	$ 15,000

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References + Details

- Definition

Amount, excluding tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value added and excise.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 924
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SAB Topic 11.L)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479941/924-10-S99-1

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 5
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-5

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 30
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-30

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 42
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-42

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 22
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-22

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 32
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-32

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 40
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-40

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 22
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-22

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 32
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-32

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 41
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-41

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 4
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-4

+ Details

Inventory (Tables)

12 Months Ended

Dec. 31, 2023

Inventory Disclosure [Abstract]

Schedule of Inventory

Inventory consisted of the following:


	December 31,
(in thousands)	2023		2022
Raw materials	$	31,259	$	19,987
Work in process	13,807		8,234
Finished goods	18,963		7,254
Total inventory	$	64,029	$	35,475

Intangibles, Net and Goodwill - Schedule of Intangibles, Net (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Aug. 02, 2023	Dec. 31, 2022
Finite-Lived Intangible Assets [Line Items]
Indefinite lived, cost			$ 15,640
Total, cost	$ 328,968		489,761
Accumulated Amortization	(176,983)		(174,476)
Total	151,985
Total, net	151,985		315,285
Trademarks
Finite-Lived Intangible Assets [Line Items]
Cost	13,540		13,540
Accumulated Amortization	(12,216)		(12,061)
Total	$ 1,324		$ 1,479
Trademarks \| Minimum
Finite-Lived Intangible Assets [Line Items]
Useful Lives (in years)	15 years		15 years
Trademarks \| Maximum
Finite-Lived Intangible Assets [Line Items]
Useful Lives (in years)	25 years		25 years
Customer relationships
Finite-Lived Intangible Assets [Line Items]
Cost	$ 157,995		$ 96,681
Accumulated Amortization	(117,574)		(95,009)
Total	$ 40,421		$ 1,672
Customer relationships \| Minimum
Finite-Lived Intangible Assets [Line Items]
Useful Lives (in years)	15 years		15 years
Customer relationships \| Maximum
Finite-Lived Intangible Assets [Line Items]
Useful Lives (in years)	25 years		25 years
Currently marketed product
Finite-Lived Intangible Assets [Line Items]
Cost	$ 132,800		$ 275,700
Accumulated Amortization	(38,277)		(47,628)
Total	$ 94,523		$ 228,072
Currently marketed product \| Minimum
Finite-Lived Intangible Assets [Line Items]
Useful Lives (in years)	9 years		9 years
Currently marketed product \| Maximum
Finite-Lived Intangible Assets [Line Items]
Useful Lives (in years)	15 years		15 years
Licenses
Finite-Lived Intangible Assets [Line Items]
Cost	$ 22,233	$ 63,600	$ 85,800
Accumulated Amortization	(7,972)	$ (17,500)	(19,101)
Total	$ 14,261		$ 66,699
Licenses \| Minimum
Finite-Lived Intangible Assets [Line Items]
Useful Lives (in years)	11 years		11 years
Licenses \| Maximum
Finite-Lived Intangible Assets [Line Items]
Useful Lives (in years)	16 years		16 years
Developed technology
Finite-Lived Intangible Assets [Line Items]
Useful Lives (in years)	9 years		9 years
Cost	$ 2,400		$ 2,400
Accumulated Amortization	(944)		(677)
Total	$ 1,456		$ 1,723

Summary of Significant Accounting Policies - Goodwill (Details) - USD ($)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Accounting Policies [Abstract]
Goodwill, impairment loss	$ 0	$ 0	$ 0

Summary of Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2023

Accounting Policies [Abstract]

Schedule of Product Concentration Risk

The following table sets forth revenues for each of the Company’s products representing 10% or more of revenues:


	Year Ended December 31,
	2023		2022		2021
PYLARIFY	65.7	%	56.4	%	10.2	%
DEFINITY	21.6	%	26.2	%	54.7	%
TechneLite	6.7	%	9.5	%	21.5	%

Schedule of Estimated Useful Lives of Major Classes of Depreciable Assets

The estimated useful lives of the major classes of depreciable assets are as follows:


Class						Range of Estimated Useful Lives
Buildings						10 - 50 years
Land improvements						15 - 40 years
Machinery and equipment						3 - 15 years
Furniture and fixtures						15 years
Leasehold improvements						Lesser of lease term or 15 years
Computer software						3 - 5 years

Property, plant and equipment, net, consisted of the following:


	December 31,
(in thousands)	2023		2022
Land	$	9,480	$	13,450
Buildings	73,441		76,329
Machinery, equipment and fixtures	102,576		92,604
Computer software	27,259		25,864
Construction in progress	40,964		14,047
	253,720		222,294
Less: accumulated depreciation and amortization	(107,023)		(100,128)
Total property, plant and equipment, net	$	146,697	$	122,166

Schedule of other loss (income)

Other loss (income) consisted of the following:


	Year Ended December 31,
(in thousands)	2023		2022		2021
Foreign currency losses	$	21	$	256	$	274
Tax indemnification expense, net	4,943		9,554		7,121
Interest income	(19,638)		(2,613)		(45)
Interest rate swap termination	—		(5,494)		—
Gain on sale of RELISTOR licensed intangible asset associated with net sales royalties	(51,789)
Other	143		—		—
Total other (income) loss	$	(66,320)	$	1,703	$	7,350

Other Assets (Tables)

12 Months Ended

Dec. 31, 2023

Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]

Schedule of Other Assets

Other assets are comprised of the following:


	December 31,
(in thousands)	2023		2022
Prepaid Expenses	$	16,437	$	12,887

Other Current Assets	246		205
Total other current assets	$	16,683	$	13,092

ROU Asset (Note 16)	$	45,325	$	19,033

Other Long-Term Assets	9,936		15,322
Total other long-term assets	$	55,261	$	34,355

Consolidated Statements of Changes in Stockholders’ Equity - USD ($) $ in Thousands	Total	Common Stock	Treasury Stock	Additional Paid-In Capital	Retained Earnings	Accumulated Other Comprehensive Loss
Beginning balance (in shares) at Dec. 31, 2020		66,875,000
Beginning balance (in shares) at Dec. 31, 2020			0
Beginning balance at Dec. 31, 2020	$ 514,205	$ 669	$ 0	$ 665,530	$ (149,946)	$ (2,048)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net (loss) income	(71,279)				(71,279)
Other comprehensive (loss) income	1,563					1,563
Stock option exercises and employee stock plan purchases (in shares)		360,000
Stock option exercises and employee stock plan purchases	6,062	$ 3		6,059
Vesting of restricted stock awards (in shares)		611,000
Vesting of restricted stock awards	0	$ 6		(6)
Shares withheld to cover taxes (in shares)		(107,000)
Shares withheld to cover taxes	(2,046)	$ (1)		(2,045)
Stock-based compensation	15,934			15,934
Ending balance (in shares) at Dec. 31, 2021		67,739,000
Ending balance (in shares) at Dec. 31, 2021			0
Ending balance at Dec. 31, 2021	464,439	$ 677	$ 0	685,472	(221,225)	(485)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net (loss) income	28,067				28,067
Other comprehensive (loss) income	(774)					(774)
Stock option exercises and employee stock plan purchases (in shares)		411,000
Stock option exercises and employee stock plan purchases	8,912	$ 4		8,908
Vesting of restricted stock awards (in shares)		845,000
Vesting of restricted stock awards	0	$ 9		(9)
Shares withheld to cover taxes (in shares)		(144,000)
Shares withheld to cover taxes	$ (7,759)	$ (1)		(7,758)
Repurchase of common stock (in shares)	(1,300,000)		1,339,000
Repurchase of common stock	$ (75,000)		$ (75,000)
Stock-based compensation	$ 29,262			29,262
Ending balance (in shares) at Dec. 31, 2022	68,851,000	68,851,000
Ending balance (in shares) at Dec. 31, 2022	1,339,000		1,339,000
Ending balance at Dec. 31, 2022	$ 447,147	$ 689	$ (75,000)	715,875	(193,158)	(1,259)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net (loss) income	326,661				326,661
Other comprehensive (loss) income	222					222
Stock option exercises and employee stock plan purchases (in shares)		245,000
Stock option exercises and employee stock plan purchases	5,749	$ 2		5,747
Vesting of restricted stock awards (in shares)		962,000
Vesting of restricted stock awards	0	$ 10		(10)
Shares withheld to cover taxes (in shares)		(195,000)
Shares withheld to cover taxes	$ (14,394)	$ (2)		(14,392)
Repurchase of common stock (in shares)	0
Stock-based compensation	$ 50,507			50,507
Ending balance (in shares) at Dec. 31, 2023	69,863,000	69,863,000
Ending balance (in shares) at Dec. 31, 2023	1,339,000		1,339,000
Ending balance at Dec. 31, 2023	$ 815,892	$ 699	$ (75,000)	$ 757,727	$ 133,503	$ (1,037)

Accumulated Other Comprehensive Loss (Tables)

12 Months Ended

Dec. 31, 2023

Equity [Abstract]

Schedule of Accumulated Other Comprehensive Loss

The components of Accumulated Other Comprehensive Loss, net of tax of zero and zero for the year ended December 31, 2023 and 2022, respectively, consisted of the following:


(in thousands)	Foreign currency translation		Unrealized loss on cash flow hedges		Accumulated other comprehensive loss
Balance at January 1, 2023	$	(1,259)	$	—	$	(1,259)
Other comprehensive income (loss) before reclassifications	222		—		222

Balance at December 31, 2023	$	(1,037)	$	—	$	(1,037)

Balance at January 1, 2022	$	(754)	$	269	$	(485)
Other comprehensive income (loss) before reclassifications	(505)		5,838		5,333
Amounts reclassified to earnings	—		(6,107)		(6,107)
Balance at December 31, 2022	$	(1,259)	$	—	$	(1,259)

Other Assets

12 Months Ended

Dec. 31, 2023

Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]

Other Assets

Other assets are comprised of the following:


	December 31,
(in thousands)	2023		2022
Prepaid Expenses	$	16,437	$	12,887

Other Current Assets	246		205
Total other current assets	$	16,683	$	13,092

ROU Asset (Note 16)	$	45,325	$	19,033

Other Long-Term Assets	9,936		15,322
Total other long-term assets	$	55,261	$	34,355

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Operating activities
Net income (loss)	$ 326,661	$ 28,067	$ (71,279)
Adjustments to reconcile net income (loss) to net cash flows from operating activities:
Depreciation, amortization and accretion	60,043	47,929	42,288
Impairment of long-lived assets	138,050	0	9,729
Asset retirement obligation acceleration	0	280	5,259
Gain on interest rate swap termination	0	(5,494)	0
Amortization of debt related costs	4,300	1,249	676
Changes in fair value of contingent assets and liabilities	(9,275)	34,700	72,400
Charges incurred in connection with acquired IPR&D	0	260,000	0
Loss (gain) on extinguishment of debt	0	588	(889)
Provision for excess and obsolete inventory	7,914	7,145	4,057
Stock-based compensation	50,507	29,262	15,934
Gain on disposal of assets	(51,789)	0	(15,263)
Deferred taxes	(55,632)	(48,016)	4,437
Long-term indemnification receivable	3,929	9,554	7,121
Long-term income tax payable and other long-term liabilities	(3,103)	(12,477)	(7,912)
Other	4,855	4,059	2,512
Changes in assets and liabilities which provided (used) cash:
Accounts receivable	(68,637)	(128,460)	(33,102)
Inventory	(36,220)	(7,508)	(3,549)
Other current assets	(2,418)	(2,440)	(73)
Other long-term assets	0	(533)	0
Accounts payable	17,189	301	5,425
Accrued expenses and other liabilities	(81,114)	63,575	16,145
Net cash provided by operating activities	305,260	281,781	53,916
Investing activities
Capital expenditures	(46,555)	(18,347)	(12,140)
Proceeds from sale of assets, net	97,839	1,800	15,823
Acquisition of assets	(45,345)	(260,000)	0
Net cash provided by (used in) investing activities	5,939	(276,547)	3,683
Financing activities
Proceeds from issuance of common stock	1,933	1,375	767
Debt issuance costs	0	(95)	0
Proceeds from issuance of long-term debt, net	0	557,750	0
Contingent value rights settlement	(3,700)	0	0
Payments on long-term debt and other borrowings	(717)	(175,385)	(43,348)
Deferred financing costs	0	(2,315)	0
Proceeds from interest rate swap termination	0	5,583	0
Proceeds from stock option exercises	3,816	7,537	5,295
Payments for minimum statutory tax withholding related to net share settlement of equity awards	(14,394)	(7,759)	(2,046)
Repurchase of common stock	0	(75,000)	0
Net cash (used in) provided by financing activities	(13,062)	311,691	(39,332)
Effect of foreign exchange rates on cash and cash equivalents	(93)	(335)	(310)
Net increase in cash and cash equivalents and restricted cash	298,044	316,590	17,957
Cash and cash equivalents and restricted cash, beginning of year	417,241	100,651	82,694
Cash and cash equivalents and restricted cash, end of year	715,285	417,241	100,651
Reconciliation to amounts within the consolidated balance sheets
Cash and cash equivalents	713,656	415,652	98,508
Restricted cash included in other long-term assets	1,629	1,589	2,143
Cash, cash equivalents and restricted cash at end of period	715,285	417,241	100,651
Supplemental disclosure of cash flow information
Interest	15,387	5,064	6,284
Income taxes, net of refunds of $25, $50 and $315, respectively	151,579	54,049	215
Schedule of non-cash investing and financing activities
Additions of property, plant and equipment included in liabilities	6,978	2,370	1,262
Right-of-use asset obtained in exchange for operating lease liabilities	$ 29,396	$ 11,019	$ 683

Consolidated Balance Sheets (Parenthetical) - $ / shares	Dec. 31, 2023	Dec. 31, 2022
Statement of Financial Position [Abstract]
Preferred stock, par value (in dollars per share)	$ 0.01	$ 0.01
Preferred stock, shares authorized (in shares)	25,000,000	25,000,000
Preferred stock, shares issued (in shares)	0	0
Preferred stock, shares outstanding (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock, shares authorized (in shares)	250,000,000	250,000,000
Common stock, shares issued (in shares)	69,863,000	68,851,000
Common stock, shares outstanding (in shares)	69,863,000	68,851,000
Treasury stock, shares (in shares)	1,339,000	1,339,000

Asset Retirement Obligations - Schedule of Reconciliation of Company's Asset Retirement Obligations (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Asset Retirement Obligation, Roll Forward Analysis [Roll Forward]
Balance at the beginning of the period	$ 22,543	$ 20,833
Change in useful life estimate		280
Accretion expense	373	1,430
Balance at the ending of the period	$ 22,916	$ 22,543

401(k) Plan (Details) - USD ($) $ in Millions	12 Months Ended
401(k) Plan (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Retirement Benefits [Abstract]
Expense recognized by the company for matching contributions	$ 4.1	$ 3.1	$ 2.6

Commitments and Contingencies

12 Months Ended

Dec. 31, 2023

Commitments and Contingencies Disclosure [Abstract]

Commitments and Contingencies

Purchase Commitments

The Company has entered into purchasing arrangements in which minimum quantities of goods or services have been committed to be purchased on an annual basis.

As of December 31, 2023, future payments required under purchase commitments are as follows:


(in thousands)	Amount
2024	2,716
2025	2,716
2026	2,716
2027	2,716
2028 and thereafter	—
Total	$	10,864

The Company has entered into agreements which contain certain percentage volume purchase requirements. The Company has excluded these future purchase commitments from the table above since there are no minimum purchase commitments or payments under these agreements.

License Agreements

The Company has entered into license agreements in which fixed payments have been committed to be paid on an annual basis.

As of December 31, 2023, no future fixed payments are required under license agreements. The Company may be required to pay additional amounts up to approximately $264.4 million in contingent payments under the Company’s license agreements. These

contingent payments include potential milestone or contractual payment obligations contingent upon the achievement or occurrence of future milestones or events and the amounts and timing of such potential obligations are unknown or uncertain.

Legal Proceedings

From time to time, the Company is a party to various legal proceedings arising in the ordinary course of business. In addition, the Company has in the past been, and may in the future be, subject to investigations by governmental and regulatory authorities, which expose it to greater risks associated with litigation, regulatory or other proceedings, as a result of which the Company could be required to pay significant fines or penalties. The costs and outcome of litigation, regulatory or other proceedings cannot be predicted with certainty, and some lawsuits, claims, actions or proceedings may be disposed of unfavorably to the Company and could have a material adverse effect on the Company’s results of operations or financial condition. In addition, intellectual property disputes often have a risk of injunctive relief which, if imposed against the Company, could materially and adversely affect its financial condition or results of operations. If a matter is both probable to result in material liability and the amount of loss can be reasonably estimated, the Company estimates and discloses the possible material loss or range of loss. If such loss is not probable or cannot be reasonably estimated, a liability is not recorded in its consolidated financial statements.

As of December 31, 2023, the Company did not have any material ongoing litigation to which the Company was a party. On January 26, 2024, the Company was sued in the United States District Court for the District of Delaware by Advanced Accelerator Applications USA, Inc. and Advanced Accelerator Applications SA, each a Novartis entity, for patent infringement in response to the filing of our ANDA and Paragraph IV certification, consistent with the process established by the Hatch-Waxman Act. Because the outcome of litigation is uncertain, the Company cannot predict how or when this matter will ultimately be resolved.

Consolidated Statements of Cash Flows (Parenthetical) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Statement of Cash Flows [Abstract]
Proceeds from income tax refunds	$ 25	$ 50	$ 315

Revenue from Contracts with Customers - Schedule Of Rebates and Allowances (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves [Roll Forward]
Beginning balance	$ 13,399	$ 10,977
Provision related to current period revenues	32,308	26,683
Adjustments relating to prior period revenues	(453)	70
Payments or credits made during the period	(29,184)	(24,331)
Ending balance	$ 16,070	$ 13,399

Inventory

12 Months Ended

Dec. 31, 2023

Inventory Disclosure [Abstract]

Inventory

Inventory consisted of the following:


	December 31,
(in thousands)	2023		2022
Raw materials	$	31,259	$	19,987
Work in process	13,807		8,234
Finished goods	18,963		7,254
Total inventory	$	64,029	$	35,475

Inventory costs associated with products that have not yet received regulatory approval are capitalized if the Company believes there is probable future commercial use of the product and future economic benefit of the asset. If future commercial use of the product is not probable, then inventory costs associated with such product are expensed during the period the costs are incurred. The Company has no inventory pending regulatory approval as of December 31, 2023.

Stock-Based Compensation - Schedule of Restricted Stock Units Activity (Details)	12 Months Ended
	Dec. 31, 2023 $ / shares shares
Shares
Nonvested beginning balance (in shares) \| shares	1,249,992
Granted (in shares) \| shares	710,985
Vested (in shares) \| shares	(612,912)
Forfeited (in shares) \| shares	(137,806)
Nonvested ending balance (in shares) \| shares	1,210,259
Weighted- Average Grant Date Fair Value Per Share
Nonvested beginning balance (in dollars per share) \| $ / shares	$ 34.65
Granted (in dollars per share) \| $ / shares	74.38
Vested (in dollars per share) \| $ / shares	29.78
Forfeited (in dollars per share) \| $ / shares	50.36
Nonvested, ending balance (in dollars per share) \| $ / shares	$ 58.71

401(k) Plan	12 Months Ended
401(k) Plan	Dec. 31, 2023
Retirement Benefits [Abstract]
401(k) Plan	401(k) Plan The Company maintains a qualified 401(k) plan (the “401(k) Plan”) for its U.S. employees. The 401(k) Plan covers U.S. employees who meet certain eligibility requirements. Under the terms of the 401(k) Plan, the employees may elect to make tax-deferred contributions through payroll deductions within statutory and plan limits, and the Company may elect to make non-elective discretionary contributions. The Company may also make optional contributions to the 401(k) Plan for any plan year at its discretion. Expense recognized by the Company for matching contributions made to the 401(k) Plan was $4.1 million, $3.1 million and $2.6 million for the years ended December 31, 2023, 2022 and 2021, respectively.

- Definition

The entire disclosure for retirement benefits.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 70
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480794/715-70-50-1

Reference 2: http://www.xbrl.org/2003/role/exampleRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section 55
-Paragraph 17
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480482/715-20-55-17

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (d)(iv)(03)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480506/715-20-50-1

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (d)(i)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480506/715-20-50-1

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (q)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480506/715-20-50-1

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (l)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480506/715-20-50-1

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org//715/tableOfContent

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (d)(iii)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480506/715-20-50-1

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (o)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480506/715-20-50-1

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (p)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480506/715-20-50-1

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (r)(1)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480506/715-20-50-1

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (r)(2)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480506/715-20-50-1

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section S99
-Paragraph 2
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480126/715-20-S99-2

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 60
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480266/715-60-50-3

+ Details

Inventory (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Inventory Disclosure [Abstract]
Raw materials	$ 31,259	$ 19,987
Work in process	13,807	8,234
Finished goods	18,963	7,254
Total inventory	$ 64,029	$ 35,475

Summary of Significant Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2023

Accounting Policies [Abstract]

Basis of Presentation

Basis of Presentation and Principles of Consolidation

The accompanying consolidated financial statements have been prepared in accordance with U.S. GAAP.

Principles of Consolidation

The consolidated financial statements include the accounts of the Company and its direct and indirect wholly-owned subsidiaries. All intercompany accounts and transactions have been eliminated in consolidation.

Use of Estimates

Revenue Recognition

Accounts Receivable, net

Income Taxes

Net Income (Loss) per Common Share

Cash and Cash Equivalents

Cash and cash equivalents include savings deposits, certificates of deposit and money market funds that have original maturities of three months or less when purchased.

Restricted Cash

Concentration of Risks and Limited Suppliers

Inventory

Property, Plant and Equipment, net


Class						Range of Estimated Useful Lives
Buildings						10 - 50 years
Land improvements						15 - 40 years
Machinery and equipment						3 - 15 years
Furniture and fixtures						15 years
Leasehold improvements						Lesser of lease term or 15 years
Computer software						3 - 5 years

Business Combinations

Goodwill

Intangible and Long-Lived Assets

Contingencies

Convertible Notes

Fair Values of Financial Instruments

Contingent Consideration Liabilities

Derivative Instruments

Advertising and Promotion Costs

Advertising and promotion costs are expensed as incurred.

Research and Development

Foreign Currency

Stock-Based Compensation

Comprehensive Income (Loss)

Asset Retirement Obligations

Self-Insurance Reserves

Recent Accounting Pronouncements

Sale of Puerto Rico Subsidiary (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2021	Mar. 31, 2023	Jan. 29, 2021
Puerto Rican Radiopharmacy Servicing Subsidiary
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Pre-tax book gain on disposal	$ 15.3
Disposal Group, Disposed of by Sale, Not Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Purchase price for stock		$ 10.0
Disposal Group, Disposed of by Sale, Not Discontinued Operations \| Puerto Rican Radiopharmacy Servicing Subsidiary
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Purchase price for stock			$ 18.0
Disposal group holdback amount			$ 1.8

Leases - Schedule of Other Information Related to Leases (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Weighted-average remaining lease term (Years):
Operating leases	13 years 6 months	7 years 10 months 24 days
Finance leases	2 years 3 months 18 days	1 year 10 months 24 days
Weighted-average discount rate:
Operating leases	7.30%	4.80%
Finance leases	6.20%	4.40%
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$ 3,462	$ 2,440
Operating cash flows from finance leases	81	28
Financing cash flows from finance leases	504	384
ROU assets obtained in exchange for lease obligations:
Operating leases	29,396	11,019	$ 683
Finance leases	$ 1,437	$ 582

Net Income (Loss) Per Common Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Debt Instrument [Line Items]
Net income (loss)	$ 326,661	$ 28,067	$ (71,279)
Basic weighted-average common shares outstanding	68,266	68,487	67,486
Effect of convertible notes (in shares)	199	0	0
Diluted weighted-average common shares outstanding (in shares)	70,239	70,671	67,486
Basic income (loss) per common share (in dollars per share)	$ 4.79	$ 0.41	$ (1.06)
Diluted income (loss) per common share (in dollars per share)	$ 4.65	$ 0.40	$ (1.06)
Antidilutive securities excluded from diluted net income (loss) per common share (in shares)	421	358	2,893
Options
Debt Instrument [Line Items]
Effect of dilutive share based compensation (in shares)	346	439	0
Restricted stock
Debt Instrument [Line Items]
Effect of dilutive share based compensation (in shares)	1,428	1,745	0

Asset Retirement Obligations

12 Months Ended

Dec. 31, 2023

Asset Retirement Obligation Disclosure [Abstract]

Asset Retirement Obligations

The Company considers its legal obligation to remediate its facilities upon a decommissioning of its radioactive-related operations as an asset retirement obligation. The Company has production facilities which manufacture and process radioactive materials at its North Billerica, Massachusetts and Somerset, New Jersey sites. As of December 31, 2023, the liability is measured at the present value of the obligation expected to be incurred, of approximately $25.1 million.

The following table provides a summary of the changes in the Company’s asset retirement obligations:


(in thousands)	Amount
Balance, January 1, 2022	$	20,833
Change in useful life estimate	280
Accretion expense	1,430
Balance, December 31, 2022	22,543

Accretion expense	373
Balance, December 31, 2023	$	22,916

The Company is required to provide the Massachusetts Department of Public Health and New Jersey Department of Environmental Protection financial assurance demonstrating the Company’s ability to fund the decommissioning of its North Billerica, Massachusetts and Somerset, New Jersey production facilities, respectively, upon closure. The Company has provided this financial assurance in the form of a $30.3 million surety bond.

Net Income (Loss) Per Common Share

12 Months Ended

Dec. 31, 2023

Earnings Per Share [Abstract]

Net Income (Loss) Per Common Share

A summary of net income (loss) per common share is presented below:


	Year Ended December 31,
(in thousands, except per share amounts)	2023		2022		2021
Net income (loss)	$	326,661	$	28,067	$	(71,279)

Basic weighted-average common shares outstanding	68,266		68,487		67,486
Effect of dilutive stock options	346		439		—

Effect of dilutive restricted stock	1,428		1,745		—
Effect of convertible debt instrument	199		—		—
Diluted weighted-average common shares outstanding	70,239		70,671		67,486

Basic income (loss) per common share	$	4.79	$	0.41	$	(1.06)
Diluted income (loss) per common share	$	4.65	$	0.40	$	(1.06)

Antidilutive securities excluded from diluted net income (loss) per common share	421		358		2,893

Impact of the Convertible Notes

The Company considered whether the notes are participating securities through the two-class method. The Company determined that if a cash dividend is paid that is greater than the then stock price, the holder of Notes will receive cash on an if-converted basis. While this feature is considered to be a participating right; basic earnings per share is only impacted if the Company’s earning exceeds the current share price, regardless of whether such dividend is declared. During the year ended December 31, 2023, no such dividend was declared. In addition, the Company is required to settle the principal amount of the Notes in cash upon conversion, and therefore, the Company uses the if-converted method for calculating any potential dilutive effect of the conversion option on diluted net income per share, if applicable, unless the application of the two-class method is dilutive. The conversion option will have a dilutive impact on net income per share of Common Stock when the average price per share of the Company’s Common Stock for a given period exceeds the conversion price of the Notes of $79.81 per share.

Commitments and Contingencies - Additional Information (Details) $ in Millions	Dec. 31, 2023 USD ($)
Commitments and Contingencies Disclosure [Abstract]
Contingent payments	$ 264.4

Accrued Expenses and Other Liabilities and Other Long-Term Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Payables and Accruals [Abstract]
Compensation and benefits	$ 36,331	$ 30,425
Freight, distribution and operations	67,529	49,067
Accrued rebates, discounts and chargebacks	16,070	13,399
Accrued professional fees	10,244	8,668
Other	15,164	25,525
Total accrued expenses and other liabilities	145,338	127,084
Operating lease liabilities (Note 16)	54,453	25,442
Long-term contingent liability (Note 4)	2,700	11,900
Other long-term liabilities	6,168	8,813
Total other long-term liabilities	$ 63,321	$ 46,155

Fair Value of Financial Instruments - Narrative (Details) - USD ($) $ in Thousands		12 Months Ended
	Feb. 20, 2020	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Fair Value, Option, Quantitative Disclosures [Line Items]
Revenues		$ 1,296,429	$ 935,061	$ 425,208
Contingent consideration liabilities		2,700	$ 111,600
Change in fair value of the contingent financial asset and contingent financial liabilities		$ 9,300
Fair Value, Net Derivative Asset (Liability), Recurring Basis, Still Held, Unrealized Gain (Loss), Statement of Income or Comprehensive Income [Extensible Enumeration]		General and administrative
Progenics
Fair Value, Option, Quantitative Disclosures [Line Items]
Royalty percentage			5.00%
Aggregate cash payments percentage	40.00%
Potential payments, high		$ 85,000
Progenics \| Cash Payments, 2022
Fair Value, Option, Quantitative Disclosures [Line Items]
Contingent consideration liabilities	$ 100,000
Progenics \| Cash Payments, 2023
Fair Value, Option, Quantitative Disclosures [Line Items]
Contingent consideration liabilities	$ 150,000
Progenics \| Net Sales Targets For Azedra
Fair Value, Option, Quantitative Disclosures [Line Items]
Potential payments, high		70,000
Progenics \| 1095 commercialization milestone
Fair Value, Option, Quantitative Disclosures [Line Items]
Potential payments, high		5,000
Progenics \| 1404 Commercialization Milestone
Fair Value, Option, Quantitative Disclosures [Line Items]
Potential payments, high		$ 10,000
Royalty \| Progenics
Fair Value, Option, Quantitative Disclosures [Line Items]
Revenues			$ 5,000

Accumulated Other Comprehensive Loss

12 Months Ended

Dec. 31, 2023

Equity [Abstract]

Accumulated Other Comprehensive Loss

The components of Accumulated Other Comprehensive Loss, net of tax of zero and zero for the year ended December 31, 2023 and 2022, respectively, consisted of the following:


(in thousands)	Foreign currency translation		Unrealized loss on cash flow hedges		Accumulated other comprehensive loss
Balance at January 1, 2023	$	(1,259)	$	—	$	(1,259)
Other comprehensive income (loss) before reclassifications	222		—		222

Balance at December 31, 2023	$	(1,037)	$	—	$	(1,037)

Balance at January 1, 2022	$	(754)	$	269	$	(485)
Other comprehensive income (loss) before reclassifications	(505)		5,838		5,333
Amounts reclassified to earnings	—		(6,107)		(6,107)
Balance at December 31, 2022	$	(1,259)	$	—	$	(1,259)

Income Taxes - Reconciliation of Uncertain Tax Positions (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Reconciliation of Uncertain Tax Positions [Roll Forward]
Beginning balance of uncertain tax positions	$ 1,480	$ 3,658	$ 5,292
Additions related to current year tax positions	3,749	0	0
Reductions related to prior year tax positions	(688)	(1,180)	(188)
Settlements	(442)	(306)	(1,446)
Lapse of statute of limitations	0	(692)	0
Ending balance of uncertain tax positions	$ 4,099	$ 1,480	$ 3,658

Property, Plant & Equipment, Net

12 Months Ended

Dec. 31, 2023

Property, Plant and Equipment [Abstract]

Property, Plant & Equipment, Net

Property, Plant and Equipment, Net

Property, plant and equipment, net, consisted of the following:


	December 31,
(in thousands)	2023		2022
Land	$	9,480	$	13,450
Buildings	73,441		76,329
Machinery, equipment and fixtures	102,576		92,604
Computer software	27,259		25,864
Construction in progress	40,964		14,047
	253,720		222,294
Less: accumulated depreciation and amortization	(107,023)		(100,128)
Total property, plant and equipment, net	$	146,697	$	122,166

Depreciation and amortization expense related to property, plant & equipment, net, was $13.2 million, $13.7 million and $13.2 million for the years ended December 31, 2023, 2022 and 2021, respectively.

The Company tests long-lived assets for recoverability whenever events or changes in circumstances suggest that the carrying value of an asset or group of assets may not be recoverable. During the year ended December 31, 2021, the Company reviewed certain facts relating to an asset group that included the right-of-use (“ROU”) asset associated with the lease of office space in the World Trade Center (the “WTC lease”) in New York City and resulted in a change to the asset group due to the negotiation of a sublease. Please refer to Note 16, “Leases” for further details.

During the three months ended June 30, 2023, as a result of a decline in expected future cash flows related to a certain asset group, the Company determined certain impairment triggers had occurred. The Company reviewed revised undiscounted cash flows that were estimated to be generated by the asset group as of June 30, 2023. Based on the undiscounted cash flow analysis, the Company determined that the asset group had net carrying values that exceeded their estimated undiscounted future cash flows. The Company then estimated the fair value of the asset group based on their discounted cash flows. The carrying value exceeded the fair value and as a result, the Company recorded a noncash impairment of $6.0 million for the six months ended June 30, 2023 in cost of goods sold in the consolidated statements of operations.

Long-Lived Assets Held for Sale

During the first quarter of 2023, the Company committed to a plan to sell a portion of its land and buildings associated with its Billerica, Massachusetts campus. Effective March 16, 2023, the Company entered into a purchase and sale agreement (the “P&S”) with a prospective buyer. The assets were classified as held for sale and comprised entirely of property, plant and equipment, net. The Company determined that the fair value of the net assets being sold exceeded the carrying value as of September 30, 2023. The purchase price for the campus sale is $10.0 million in cash. The transaction is expected to close in the second or third quarter of 2024.

Stock-Based Compensation - Equity Incentive Plans (Details)	Dec. 31, 2023 shares
Share-Based Payment Arrangement [Abstract]
Share based compensation, shares authorized (in shares)	10,930,277

Property, Plant & Equipment, Net (Tables)

12 Months Ended

Dec. 31, 2023

Property, Plant and Equipment [Abstract]

Schedule of Property, Plant, and Equipment, Net

The estimated useful lives of the major classes of depreciable assets are as follows:


Class						Range of Estimated Useful Lives
Buildings						10 - 50 years
Land improvements						15 - 40 years
Machinery and equipment						3 - 15 years
Furniture and fixtures						15 years
Leasehold improvements						Lesser of lease term or 15 years
Computer software						3 - 5 years

Property, plant and equipment, net, consisted of the following:


	December 31,
(in thousands)	2023		2022
Land	$	9,480	$	13,450
Buildings	73,441		76,329
Machinery, equipment and fixtures	102,576		92,604
Computer software	27,259		25,864
Construction in progress	40,964		14,047
	253,720		222,294
Less: accumulated depreciation and amortization	(107,023)		(100,128)
Total property, plant and equipment, net	$	146,697	$	122,166

Consolidated Statements of Comprehensive Income (Loss) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Statement of Comprehensive Income [Abstract]
Net income (loss)	$ 326,661	$ 28,067	$ (71,279)
Other comprehensive income:
Foreign currency translation	222	(505)	(124)
Realized loss on cash flow hedges, net of tax	0	(269)	0
Unrealized gain on cash flow hedges, net of tax	0	0	1,687
Total other comprehensive income (loss)	222	(774)	1,563
Comprehensive income (loss)	$ 326,883	$ 27,293	$ (69,716)

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(g)(1)(ii))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-1

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 323
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481687/323-10-50-3

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 825
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 28
-Subparagraph (f)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482907/825-10-50-28

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 220
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+ Details

Consolidated Statements of Operations - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Statement [Abstract]
Revenues	$ 1,296,429	$ 935,061	$ 425,208
Cost of goods sold	586,886	353,358	237,513
Gross profit	709,543	581,703	187,695
Operating expenses
Sales and marketing	141,736	100,243	68,422
General and administrative	125,458	133,584	150,395
Research and development	77,707	311,681	44,966
Total operating expenses	344,901	545,508	263,783
Gain on sales of assets	0	0	15,263
Operating income (loss)	364,642	36,195	(60,825)
Interest expense	20,019	7,185	7,752
Loss (gain) on extinguishment of debt	0	588	(889)
Other (income) loss, net	(66,320)	1,703	7,350
Income (loss) before income taxes	410,943	26,719	(75,038)
Income tax expense (benefit)	84,282	(1,348)	(3,759)
Net income (loss)	$ 326,661	$ 28,067	$ (71,279)
Net income (loss) per common share:
Basic (in dollars per share)	$ 4.79	$ 0.41	$ (1.06)
Diluted (in dollars per share)	$ 4.65	$ 0.40	$ (1.06)
Weighted-average common shares outstanding:
Basic (in shares)	68,266	68,487	67,486
Diluted (in shares)	70,239	70,671	67,486

Summary of Significant Accounting Policies - Narrative (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2021	Dec. 31, 2023
Debt Instrument [Line Items]
Measurement period adjustment	$ 2.6
Convertible Debt
Debt Instrument [Line Items]
Fair value of debt		$ 644.3
2.625% Convertible Senior Notes due 2027 \| Senior Notes
Debt Instrument [Line Items]
Interest rate		2.625%

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

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+ Details

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Current assets
Cash and cash equivalents	$ 713,656	$ 415,652
Accounts receivable, net	284,292	213,397
Inventory	64,029	35,475
Other current assets	16,683	13,092
Assets held for sale	7,159	0
Total current assets	1,085,819	677,616
Property, plant and equipment, net	146,697	122,166
Intangibles, net	151,985	315,285
Goodwill	61,189	61,189
Deferred tax assets, net	150,198	110,647
Other long-term assets	55,261	34,355
Total assets	1,651,149	1,321,258
Current liabilities
Current portion of long-term debt and other borrowings	823	354
Accounts payable	41,189	20,563
Short-term contingent liability	0	99,700
Accrued expenses and other liabilities	145,338	127,084
Total current liabilities	187,350	247,701
Asset retirement obligations	22,916	22,543
Total long-term debt, net, and other borrowings	561,670	557,712
Other long-term liabilities	63,321	46,155
Total liabilities	835,257	874,111
Commitments and contingencies (see Note 19)
Stockholders’ equity
Preferred stock ($0.01 par value, 25,000 shares authorized; no shares issued and outstanding)	0	0
Common stock ($0.01 par value, 250,000 shares authorized; 69,863 and 68,851 shares issued as of December 31, 2023 and 2022, respectively)	699	689
Additional paid-in capital	757,727	715,875
Treasury Stock at cost - 1,339 shares as of December 31, 2023 and 2022	(75,000)	(75,000)
Retained earnings (accumulated deficit)	133,503	(193,158)
Accumulated other comprehensive loss	(1,037)	(1,259)
Total stockholders’ equity	815,892	447,147
Total liabilities and stockholders’ equity	$ 1,651,149	$ 1,321,258

Fair Value of Financial Instruments

12 Months Ended

Dec. 31, 2023

Fair Value Disclosures [Abstract]

Fair Value of Financial Instruments

Fair value is defined as the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date. In order to increase consistency and comparability of fair value measurements, financial instruments are categorized based on a hierarchy that prioritizes observable and unobservable inputs used to measure fair value into three broad levels, which are described below:

•Level 1 — Inputs are unadjusted quoted prices in active markets for identical assets or liabilities that the Company has the ability to access at the measurement date.

•Level 2 — Inputs include quoted prices for similar assets and liabilities in active markets, quoted prices for identical or similar assets or liabilities in markets that are not active, inputs other than quoted prices that are observable for the asset or liability (i.e., interest rates, yield curves, etc.) and inputs that are derived principally from or corroborated by observable market data by correlation or other means (market corroborated inputs).

•Level 3 — Unobservable inputs that reflect a Company’s estimates about the assumptions that market participants would use in pricing the asset or liability. The Company develops these inputs based on the best information available, including its own data.

The Company’s financial assets and liabilities measured at fair value on a recurring basis consist of money market funds, interest rate swaps, a contingent receivable and contingent consideration liabilities. The Company invests excess cash from its operating cash accounts in overnight investments and reflects these amounts in cash and cash equivalents in the consolidated balance sheets at fair value using quoted prices in active markets for identical assets. The fair value of the interest rate swaps is determined based on observable market-based inputs, including interest rate curves and reflects the contractual terms of these instruments, including the period to maturity. Please refer to Note 13, “Derivative Instruments”, for further details on the interest rate swaps. The Company recorded a contingent receivable and the contingent consideration liabilities resulting from the Progenics Acquisition at fair value based on inputs that are not observable in the market.

The tables below present information about the Company’s assets and liabilities measured at fair value on a recurring basis:


	December 31, 2023
(in thousands)	Total Fair Value		Level 1		Level 2		Level 3
Assets:
Money market funds	$	574,131	$	574,131	$	—	$	—


Total assets	$	574,131	$	574,131	$	—	$	—
Liabilities:

Contingent consideration liabilities	$	2,700	$	—	$	—	$	2,700
Total liabilities	$	2,700	$	—	$	—	$	2,700


	December 31, 2022
(in thousands)	Total Fair Value		Level 1		Level 2		Level 3
Assets:
Money market funds	$	342,646	$	342,646	$	—	$	—


Total assets	$	342,646	$	342,646	$	—	$	—
Liabilities:

Contingent consideration liabilities	$	111,600	$	—	$	—	$	111,600
Total liabilities	$	111,600	$	—	$	—	$	111,600

During the years ended December 31, 2023 and 2022, there were no transfers into or out of Level 3. On December 2, 2022, the Company voluntarily terminated the interest rate swap contracts in connection with the refinancing of debt.

As part of the Progenics Acquisition, the Company acquired the right to receive certain future milestone and royalty payments due to Progenics from CytoDyn Inc. (“CytoDyn”) related to a prior sale of certain intellectual property. The Company has the right to receive $5.0 million upon regulatory approval and a 5% royalty on net sales of approved products. The Company considers the contingent receivable a Level 3 instrument (one with significant unobservable inputs) in the fair value hierarchy. The estimated fair value was determined based on probability adjusted discounted cash flows that included significant estimates and assumptions

pertaining to regulatory events and sales targets. During the fourth quarter of 2022, the Company reduced the probability to zero as CytoDyn withdrew their regulatory application. The most significant unobservable inputs are the probabilities of achieving regulatory approval of the development projects and subsequent commercial success.

As part of the Progenics Acquisition, the Company issued CVRs and recorded the fair value as part of consideration transferred. Each CVR entitled its holder to receive a pro rata share of aggregate cash payments equal to 40% of U.S. net sales generated by PYLARIFY in 2022 and 2023 in excess of $100.0 million and $150.0 million, respectively, subject to a maximum cap. Refer to Note 1, “Basis of Presentation” for further details on the CVRs. The Company paid out the maximum amount payable under the CVRs from available cash in May 2023 in full satisfaction of the CVR obligation.

The Company also assumed contingent consideration liabilities related to a previous acquisition completed by Progenics in 2013 (“2013 Acquisition”). These contingent consideration liabilities include potential payments of up to $70.0 million if the Company attains certain net sales targets primarily for AZEDRA and 1095 (also known as 131 I-MIP-1095) and a $5.0 million 1095 commercialization milestone. Additionally, there is a potential payment of up to $10.0 million related to a 1404 commercialization milestone. The Company’s total potential payments related to the 2013 Acquisition are approximately $85.0 million. The Company considers the contingent consideration liabilities relating to the 2013 Acquisition each a Level 3 instrument (one with significant unobservable inputs) in the fair value hierarchy. The estimated fair value of these was determined based on probability adjusted discounted cash flows and Monte Carlo simulation models that included significant estimates and assumptions pertaining to commercialization events and sales targets. The most significant unobservable inputs with respect to 1095 and 1404 are the probabilities of achieving regulatory approval of those development projects and subsequent commercial success.

Significant changes in any of the probabilities of success, the probabilities as to the periods in which sales targets and milestones will be achieved, discount rates or underlying revenue forecasts would result in a significantly higher or lower fair value measurement. The Company records the contingent consideration liability at fair value with changes in estimated fair values recorded in general and administrative expenses in the consolidated statements of operations. The Company can give no assurance that the actual amounts paid, if any, in connection with the contingent consideration liabilities will be consistent with any recurring fair value estimate of such contingent consideration liabilities.

The following tables summarize quantitative information and assumptions pertaining to the fair value measurement of liabilities using Level 3 inputs as of December 31, 2023.


	Fair Value as of						Assumptions
(in thousands)	December 31, 2023		December 31, 2022		Valuation Technique	Unobservable Input	December 31, 2023		December 31, 2022
Contingent consideration liability:
Net sales targets – PYLARIFY (CVRs)	N/A		$	99,700	Probability adjusted discounted cash flow model	Period of expected milestone achievement and sales targets	N/A		2022 – 2023
						Probability of success	N/A		100	%

1095 commercialization milestone	1,800		1,700		Probability adjusted discounted cash flow model
						Period of expected milestone achievement	2026		2026
						Probability of success	40	%	40	%
						Discount rate	4.1	%	3.8	%



Net sales targets – AZEDRA and 1095	900		10,200		Monte Carlo simulation
						Probability of success and sales targets	0% - 40%		20% - 100%
						Discount rate	15%		16% - 17%
Total	$	2,700	$	111,600

For those financial instruments with significant Level 3 inputs, the following table summarizes the activities for the periods indicated:


	Financial Assets				Financial Liabilities
(in thousands)	Years Ended December 31,				Years Ended December 31,
	2023		2022		2023		2022
Fair value, beginning of period	$	—	$	9,300	$	111,600	$	86,200

Changes in fair value included in net income (loss)	—		(9,300)		(9,275)		25,400
Cash Payments	—		—		(99,625)		—

Fair value, end of period	$	—	$	—	$	2,700	$	111,600

The change in fair value of the contingent financial asset and contingent financial liabilities, including the CVRs, resulted in a general and administrative expense of $9.3 million for the year ended December 31, 2023 and was primarily due to changes in revenue forecasts, changes in market conditions, an increase in discount rates (excluding the CVRs) and the passage of time. The Company made the applicable cash payment related to the CVRs in May 2023.

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References + Details

Long-Term Debt, Net, and Other Borrowings

12 Months Ended

Dec. 31, 2023

Debt Disclosure [Abstract]

Long-Term Debt, Net, and Other Borrowings

As of December 31, 2023, the Company’s maturities of principal obligations under its long-term debt and other borrowings are as follows:


(in thousands)	Amount
2024	$	—
2025	—
2026	—
2027	575,000
2028	—
Total principal outstanding	575,000

Unamortized debt issuance costs	(13,955)
Finance lease liabilities	1,448
Total	562,493
Less: current portion	(823)
Total long-term debt, net, and other borrowings	$	561,670

In December 2022, the Company refinanced its existing credit facility, consisting of (i) a $200.0 million five-year term loan facility (the “2019 Term Facility”) and (ii) a $200.0 million five-year revolving credit facility (the “2019 Revolving Facility” and, together with the 2019 Term Facility, the “2019 Facility”), with a new $100.0 million delayed draw term loan facility (the “2022 Term

Facility” and, the loans thereunder, the “Term Loans”) and a new $350.0 million five-year revolving credit facility (the “2022 Revolving Facility” and, together with the 2022 Term Facility, the “2022 Facility”).

The Company used approximately $7.8 million of cash on hand to primarily repay the principal amount of the loans outstanding related to the 2019 Facility through the nine months ended September 30, 2022. In addition, in December 2022, the Company used approximately $167.6 million of cash on hand to repay in full the aggregate remaining principal amount of the loans outstanding under the 2019 Facility and to pay related interest, transaction fees and expenses.

The Company paid off the 2019 Term Facility using available cash and did not utilize another term loan to fund the payoff. While the 2022 Term Facility allowed for a delayed draw term loan, the loan was not drawn upon. The Company recorded a loss on extinguishment of debt of $0.6 million related to the write-off of unamortized debt issuance costs and debt discounts associated with the 2019 Term Facility. In addition, the Company incurred and capitalized $2.7 million of new deferred financing costs related to the refinancing.

2022 Revolving Facility

Under the terms of the 2022 Revolving Facility, the lenders are committed to extending credit to the Company from time to time until December 2, 2027 consisting of revolving loans (the “Revolving Loans”) in an aggregate principal amount not to exceed $350.0 million (the “Revolving Commitment”) at any time, including a $20.0 million sub-facility for the issuance of letters of credit (the “Letters of Credit”) and a $10.0 million sub-facility for swingline loans (the “Swingline Loans”). The Letters of Credit, Swingline Loans and the Revolving Loans, if used, are expected to be used for working capital and for other general corporate purposes.

The Revolving Loans bear interest, with pricing based from time to time at the Company’s election, at (i) the secured overnight financing rate as published by the Federal Reserve Bank of New York on its website plus an applicable margin that ranges from 1.50% to 2.50% based on the Company’s total net leverage ratio or (ii) the alternative base rate plus an applicable margin that ranges from 0.50% to 1.50% based on the Company’s total net leverage ratio. The 2022 Revolving Facility also includes an unused commitment fee at a rate ranging from 0.15% to 0.35% per annum based on the Company’s total net leverage ratio.

The Company is permitted to voluntarily prepay the Revolving Loans, in whole or in part, or reduce or terminate the Revolving Commitment, in each case, without premium or penalty. On any business day on which the total amount of outstanding Revolving Loans, Letters of Credit and Swingline Loans exceeds the total Revolving Commitment, the Company must prepay the Revolving Loans in an amount equal to such excess. The Company is not required to make mandatory prepayments under the 2022 Revolving Facility. As of December 31, 2023, there were no outstanding borrowings under the 2022 Revolving Facility.

The Company has the right to request an increase to the Revolving Commitment in an aggregate principal amount of up to the sum of $335.0 million or consolidated EBITDA for the four consecutive fiscal quarters most recently ended, plus additional amounts in certain circumstances (collectively, the “Incremental Cap”), minus certain incremental term loans made pursuant to specified incremental term loan commitments (“Incremental Term Loans”). The Company has the right to request Incremental Term Loans in an aggregate principal amount of up to the Incremental Cap less any incremental increases to the Revolving Commitment. Proceeds of Incremental Term Loans may be used for working capital and for other general corporate purposes and will bear interest at rates agreed between the Company and the lenders providing the Incremental Term Loans.

2022 Facility Covenants

The 2022 Facility contains a number of affirmative, negative and reporting covenants, as well as financial maintenance covenants pursuant to which the Company is required to be in quarterly compliance, measured on a trailing four quarter basis, with two financial covenants. The minimum interest coverage ratio, commencing with the fiscal quarter ended December 31, 2022, must be at least 3.00 to 1.00. The maximum total net leverage ratio permitted by the financial covenant, commencing with the fiscal quarter ending March 31, 2024, is 3.50 to 1.00.

The 2022 Facility contains usual and customary restrictions on the ability of the Company and its subsidiaries to: (i) incur additional indebtedness (ii) create liens; (iii) consolidate, merge, sell or otherwise dispose of all or substantially all of its assets; (iv) sell certain assets; (v) pay dividends on, repurchase or make distributions in respect of capital stock or make other restricted payments; (vi) make certain investments; (vii) repay subordinated indebtedness prior to stated maturity; and (viii) enter into certain transactions with its affiliates.

Upon an event of default, the Administrative Agent will have the right to declare the loans and other obligations outstanding under the 2022 Facility immediately due and payable and all commitments immediately terminated.

The 2022 Facility is guaranteed by Holdings, and certain subsidiaries of LMI, including Progenics and Lantheus MI Real Estate, LLC, and obligations under the 2022 Facility are generally secured by first priority liens over substantially all of the assets of each of

LMI, Holdings, and certain subsidiaries of LMI, including Progenics and Lantheus MI Real Estate, LLC (subject to customary exclusions set forth in the transaction documents) owned as of December 2, 2022 or thereafter acquired.

Convertible Notes

On December 8, 2022, the Company issued $575.0 million in aggregate principal amount of 2.625% Convertible Senior Notes due 2027 (the “Notes”), which includes $75.0 million in aggregate principal amount of Notes sold pursuant to the full exercise of the initial purchasers’ option to purchase additional Notes. The Notes were issued under an indenture, dated as of December 8, 2022 (the “Indenture”), among the Company, LMI (the “Guarantor”), a wholly owned subsidiary of the Company, as Guarantor, and U.S. Bank Trust Company, National Association, as Trustee. The net proceeds from the issuance of the Notes were approximately $557.8 million after deducting the initial purchasers’ discounts and offering expenses payable by the Company.

The Notes are senior unsecured obligations of the Company. The Notes are fully and unconditionally guaranteed on a senior unsecured basis by the Guarantor. The Notes bear interest at a rate of 2.625% per year, payable semi-annually in arrears on June 15 and December 15 of each year, beginning on June 15, 2023, and will mature on December 15, 2027 unless earlier redeemed, repurchased or converted in accordance with their terms. The initial conversion rate for the Notes is 12.5291 shares of the Company’s common stock per $1,000 in principal amount of Notes (which is equivalent to an initial conversion price of approximately $79.81 per share of the Company’s common stock, representing an initial conversion premium of approximately 42.5% above the closing price of $56.01 per share of the Company’s common stock on December 5, 2022). In no event shall the conversation rate per $1,000 in principal amount of notes exceed 17.8539 shares of the Company’s common stock. Prior to the close of business on the business day immediately preceding September 15, 2027, the Notes may be converted at the option of the holders only upon occurrence of specified events and during certain periods, and thereafter until the close of business on the business day immediately preceding the maturity date, the Notes may be converted at any time. The Company will satisfy any conversion by paying cash up to the aggregate principal amount of the Notes to be converted and by paying or delivering, as the case may be, cash, shares of the Company’s common stock, or a combination of cash and shares of the Company’s common stock, at its election, in respect of the remainder, if any, of its conversion obligation in excess of the aggregate principal amount of the Notes being converted. The Company may redeem for cash all or any portion of the Notes, at its option, on or after December 22, 2025 if the closing sale price per share of the Company’s common stock exceeds 130% of the conversion price of the Notes for a specified period of time. The redemption price will be equal to 100% of the principal amount of the Notes to be redeemed, plus accrued and unpaid interest, if any, to, but excluding, the redemption date.

The Company evaluated the Notes upon completion of the sale and concluded on the following features:

•Conversion Feature: The Company determined that the conversion feature qualifies for the classification of equity. As a result, the conversion feature should not be bifurcated as a derivative instrument and the Notes were accounted for as a single liability.

•Redemption Features: The redemption features were reviewed within the Notes and the Company determined that the redemption features are closely related to the Notes and as such should not be separately accounted for as a bifurcated derivative instrument.

•Additional Interest Features: The Notes may result in additional interest if the Company fails to timely file any document or report that the Company is required to file with the SEC pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934. The Company will pay additional interest on the notes at a rate equal to 0.25% to 0.50% per annum based on the principal amount of notes outstanding for each day the Company failure to file has occurred or the notes are not otherwise freely tradable. Further, if the notes are assigned a restricted CUSIP number or the notes are not otherwise freely tradable pursuant to Rule 144 under the Securities Act by holders other than our affiliates or holders that were our affiliates at any time during the three months immediately preceding as of the 385th day after the last date of original issuance of the notes offered hereby, the Company will pay additional interest on the notes at a rate equal to (i) 0.25% to 0.50% per annum based on the principal amount of notes outstanding for each day until the restrictive legend has been removed from the notes, the notes are assigned an unrestricted CUSIP and the notes are freely tradable. The Company concluded that the interest feature is unrelated to the credit risk and should be bifurcated from the Notes, however, the Company assessed the probabilities of triggering events occurring under these features and does not expect to trigger the aforementioned events. These events will continue to be monitored to determine whether the interest feature will be bifurcated if it has value.

As of December 31, 2023, the carrying value of the Notes was $575.0 million, had an unamortized discount of zero, and the fair value of the liability was $575.0 million. The Company recorded interest expense of approximately $15.1 million related to the Notes for the year ended December 31, 2023.

- Definition

The entire disclosure for information about short-term and long-term debt arrangements, which includes amounts of borrowings under each line of credit, note payable, commercial paper issue, bonds indenture, debenture issue, own-share lending arrangements and any other contractual agreement to repay funds, and about the underlying arrangements, rationale for a classification as long-term, including repayment terms, interest rates, collateral provided, restrictions on use of assets and activities, whether or not in compliance with debt covenants, and other matters important to users of the financial statements, such as the effects of refinancing and noncompliance with debt covenants.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Subparagraph (h)
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Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(c))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-1

Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef
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-URI https://asc.fasb.org//470/tableOfContent

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
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-Section 50
-Paragraph 1B
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Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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-Paragraph 1B
-Subparagraph (g)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1B

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
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-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
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-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1B

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
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Reference 10: http://www.xbrl.org/2003/role/disclosureRef
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Reference 11: http://www.xbrl.org/2003/role/disclosureRef
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-Topic 470
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-Section 50
-Paragraph 1I
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-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1I

+ Details

Fair Value of Financial Instruments - Schedule of Assets and Liabilities Measured at Fair Value on A Recurring Basis (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total assets	$ 574,131	$ 342,646
Contingent consideration liabilities	2,700	111,600
Total liabilities	2,700	111,600
Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total assets	574,131	342,646
Contingent consideration liabilities	0	0
Total liabilities	0	0
Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total assets	0	0
Contingent consideration liabilities	0	0
Total liabilities	0	0
Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total assets	0	0
Contingent consideration liabilities	2,700	111,600
Total liabilities	2,700	111,600
Money market funds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Money market funds	574,131	342,646
Money market funds \| Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Money market funds	574,131	342,646
Money market funds \| Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Money market funds	0	0
Money market funds \| Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Money market funds	$ 0	$ 0

Other Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]
Prepaid Expenses	$ 16,437	$ 12,887
Other Current Assets	246	205
Total other current assets	16,683	13,092
ROU Asset	45,325	19,033
Other Long-Term Assets	9,936	15,322
Total other long-term assets	$ 55,261	$ 34,355

Cover Page - USD ($) $ in Millions	12 Months Ended
Cover Page - USD ($) $ in Millions	Dec. 31, 2023	Feb. 15, 2024	Jun. 30, 2023
Cover [Abstract]
Document Type	10-K
Document Annual Report	true
Document Period End Date	Dec. 31, 2023
Current Fiscal Year End Date	--12-31
Document Transition Report	false
Entity File Number	001-36569
Entity Registrant Name	LANTHEUS HOLDINGS, INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	35-2318913
Entity Address, Address Line One	201 Burlington Road, South Building
Entity Address, City or Town	Bedford
Entity Address, State or Province	MA
Entity Address, Postal Zip Code	01730
City Area Code	978
Local Phone Number	671-8001
Title of 12(b) Security	Common Stock, $0.01 par value per share
Trading Symbol	LNTH
Security Exchange Name	NASDAQ
Entity Well-known Seasoned Issuer	Yes
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
ICFR Auditor Attestation Flag	true
Document Financial Statement Error Correction	false
Entity Shell Company	false
Entity Public Float			$ 5,672.5
Entity Common Stock, Shares Outstanding		68,525,556
Documents Incorporated by Reference	DOCUMENTS INCORPORATED BY REFERENCE Listed hereunder are the documents, portions of which are incorporated by reference, and the parts of this Form 10-K into which such portions are incorporated: The Registrant’s Definitive Proxy Statement for use in connection with the Annual Meeting of Stockholders to be held on April 25, 2024, portions of which are incorporated by reference into Parts II and III of this Form 10-K. The 2024 Proxy Statement will be filed with the Securities and Exchange Commission no later than 120 days after the close of our year ended December 31, 2023.
Amendment Flag	false
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	FY
Entity Central Index Key	0001521036

Stock-Based Compensation - Schedule Common Stock Repurchases (Details) - USD ($)	1 Months Ended	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2023	Dec. 31, 2022
Share-Based Payment Arrangement [Abstract]
Stock repurchase program, authorized amount	$ 150,000,000		$ 150,000,000
Net proceeds from the notes	$ 75,000,000
Sale of stock, price per share (in dollars per share)	$ 56.01		$ 56.01
Repurchase of common stock (in shares)		0	1,300,000
Repurchase of common stock			$ 75,000,000

- Definition

Number of shares that have been repurchased during the period and have not been retired and are not held in treasury. Some state laws may govern the circumstances under which an entity may acquire its own stock and prescribe the accounting treatment therefore. This element is used when state law does not recognize treasury stock.

+ References + Details

- Definition

Equity impact of the value of stock that has been repurchased during the period and has not been retired and is not held in treasury. Some state laws may mandate the circumstances under which an entity may acquire its own stock and prescribe the accounting treatment therefore. This element is used when state law does not recognize treasury stock.

+ References + Details

Revenue from Contracts with Customers - Schedule of Disaggregation of Revenue (Details) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Disaggregation of Revenue [Line Items]
Total revenues		$ 1,296,429	$ 935,061	$ 425,208
Product revenue, net
Disaggregation of Revenue [Line Items]
Total revenues		1,263,068	887,038	400,356
License and royalty revenues
Disaggregation of Revenue [Line Items]
Total revenues		33,361	48,023	24,852
Total radiopharmaceutical oncology
Disaggregation of Revenue [Line Items]
Total revenues		854,433	531,507	48,887
PYLARIFY
Disaggregation of Revenue [Line Items]
Total revenues		851,303	527,405	43,414
Other radiopharmaceutical oncology
Disaggregation of Revenue [Line Items]
Total revenues		3,130	4,102	5,473
Total precision diagnostics
Disaggregation of Revenue [Line Items]
Total revenues		390,118	356,682	351,025
DEFINITY
Disaggregation of Revenue [Line Items]
Total revenues		279,768	244,993	232,759
TechneLite
Disaggregation of Revenue [Line Items]
Total revenues		87,370	88,864	91,293
Other precision diagnostics
Disaggregation of Revenue [Line Items]
Total revenues		22,980	22,825	26,973
Strategic Partnerships and other revenue
Disaggregation of Revenue [Line Items]
Total revenues		$ 51,878	$ 46,872	$ 25,296
License and Royalty Revenues, Sales-Based Milestone Payment
Disaggregation of Revenue [Line Items]
Total revenues	$ 15,000

Fair Value of Financial Instruments - Schedule of Quantitative Information and Assumptions Pertaining To The Fair Value Measurement of The Level 3 Inputs (Details) $ in Thousands	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)
Fair Value, Option, Quantitative Disclosures [Line Items]
Contingent consideration liabilities	$ 2,700	$ 111,600
Level 3
Fair Value, Option, Quantitative Disclosures [Line Items]
Contingent consideration liabilities	2,700	111,600
Net sales targets – PYLARIFY (CVRs) \| Level 3
Fair Value, Option, Quantitative Disclosures [Line Items]
Contingent consideration liabilities		$ 99,700
Net sales targets – PYLARIFY (CVRs) \| Level 3 \| Probability of success and sales targets \| Probability adjusted discounted cash flow model
Fair Value, Option, Quantitative Disclosures [Line Items]
Liability measurement input		1
1095 commercialization milestone \| Level 3
Fair Value, Option, Quantitative Disclosures [Line Items]
Contingent consideration liabilities	$ 1,800	$ 1,700
1095 commercialization milestone \| Level 3 \| Probability of success and sales targets \| Probability adjusted discounted cash flow model
Fair Value, Option, Quantitative Disclosures [Line Items]
Liability measurement input	0.40	0.40
1095 commercialization milestone \| Level 3 \| Discount rate \| Probability adjusted discounted cash flow model
Fair Value, Option, Quantitative Disclosures [Line Items]
Liability measurement input	0.041	0.038
Net sales targets – AZEDRA and 1095 \| Level 3
Fair Value, Option, Quantitative Disclosures [Line Items]
Contingent consideration liabilities	$ 900	$ 10,200
Net sales targets – AZEDRA and 1095 \| Level 3 \| Probability of success and sales targets \| Monte Carlo simulation \| Minimum
Fair Value, Option, Quantitative Disclosures [Line Items]
Liability measurement input	0	0.20
Net sales targets – AZEDRA and 1095 \| Level 3 \| Probability of success and sales targets \| Monte Carlo simulation \| Maximum
Fair Value, Option, Quantitative Disclosures [Line Items]
Liability measurement input	0.40	1
Net sales targets – AZEDRA and 1095 \| Level 3 \| Discount rate \| Monte Carlo simulation
Fair Value, Option, Quantitative Disclosures [Line Items]
Liability measurement input	0.15
Net sales targets – AZEDRA and 1095 \| Level 3 \| Discount rate \| Monte Carlo simulation \| Minimum
Fair Value, Option, Quantitative Disclosures [Line Items]
Liability measurement input		0.16
Net sales targets – AZEDRA and 1095 \| Level 3 \| Discount rate \| Monte Carlo simulation \| Maximum
Fair Value, Option, Quantitative Disclosures [Line Items]
Liability measurement input		0.17

Intangibles, Net and Goodwill (Tables)

12 Months Ended

Dec. 31, 2023

Goodwill and Intangible Assets Disclosure [Abstract]

Schedule of Finite-Lived Intangibles

Intangibles, net, consisted of the following:


	December 31, 2023
(in thousands)	Useful Lives (in years)	Amortization Method	Cost		Accumulated Amortization		Net
Trademarks	15 – 25	Straight-Line	$	13,540	$	(12,216)	$	1,324
Customer relationships	15 – 25	Accelerated	157,995		(117,574)		40,421
Currently marketed product	9 – 15	Straight-Line	132,800		(38,277)		94,523
Licenses	11 – 16	Straight-Line	22,233		(7,972)		14,261
Developed technology	9	Straight-Line	2,400		(944)		1,456

Total			$	328,968	$	(176,983)	$	151,985


	December 31, 2022
(in thousands)	Useful Lives (in years)	Amortization Method	Cost		Accumulated Amortization		Net
Trademarks	15 – 25	Straight-Line	$	13,540	$	(12,061)	$	1,479
Customer relationships	15 – 25	Accelerated	96,681		(95,009)		1,672
Currently marketed product	9 – 15	Straight-Line	275,700		(47,628)		228,072
Licenses	11 – 16	Straight-Line	85,800		(19,101)		66,699
Developed technology	9	Straight-Line	2,400		(677)		1,723
IPR&D	N/A	N/A	15,640		—		15,640
Total			$	489,761	$	(174,476)	$	315,285

Schedule of Indefinite-Lived Intangible Assets

Intangibles, net, consisted of the following:


	December 31, 2023
(in thousands)	Useful Lives (in years)	Amortization Method	Cost		Accumulated Amortization		Net
Trademarks	15 – 25	Straight-Line	$	13,540	$	(12,216)	$	1,324
Customer relationships	15 – 25	Accelerated	157,995		(117,574)		40,421
Currently marketed product	9 – 15	Straight-Line	132,800		(38,277)		94,523
Licenses	11 – 16	Straight-Line	22,233		(7,972)		14,261
Developed technology	9	Straight-Line	2,400		(944)		1,456

Total			$	328,968	$	(176,983)	$	151,985


	December 31, 2022
(in thousands)	Useful Lives (in years)	Amortization Method	Cost		Accumulated Amortization		Net
Trademarks	15 – 25	Straight-Line	$	13,540	$	(12,061)	$	1,479
Customer relationships	15 – 25	Accelerated	96,681		(95,009)		1,672
Currently marketed product	9 – 15	Straight-Line	275,700		(47,628)		228,072
Licenses	11 – 16	Straight-Line	85,800		(19,101)		66,699
Developed technology	9	Straight-Line	2,400		(677)		1,723
IPR&D	N/A	N/A	15,640		—		15,640
Total			$	489,761	$	(174,476)	$	315,285

Schedule of Expected Future Amortization Expense

The below table summarizes the estimated aggregate amortization expense expected to be recognized on the above intangible assets:


(in thousands)	Amount
2024	$	39,726
2025	24,409
2026	25,206
2027	19,680
2028	16,195
2029 and thereafter	26,769
Total	$	151,985

Property, Plant & Equipment, Net - Additional Information (Details) - USD ($) $ in Millions	6 Months Ended	12 Months Ended
	Jun. 30, 2023	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Mar. 31, 2023
Property, Plant & Equipment [Line Items]
Depreciation and amortization expense		$ 13.2	$ 13.7	$ 13.2
Noncash impairment	$ 6.0
Disposal Group, Disposed of by Sale, Not Discontinued Operations
Property, Plant & Equipment [Line Items]
Disposal group consideration					$ 10.0

Long-Term Debt, Net, and Other Borrowings - Additional Information (Details)			1 Months Ended		9 Months Ended	12 Months Ended
	Dec. 08, 2022 USD ($) $ / shares	Dec. 05, 2022	Dec. 31, 2022 USD ($)	Dec. 31, 2022 USD ($)	Sep. 30, 2022 USD ($)	Dec. 31, 2023 USD ($) financial_covenant $ / shares	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)
Debt Instrument [Line Items]
Gain (loss) on extinguishment of debt						$ 0	$ (588,000)	$ 889,000
Number of covenants \| financial_covenant						2
Minimum interest coverage ratio			3.00	3.00			3.00
Convertible Debt
Debt Instrument [Line Items]
Extinguishment of debt, amount	$ 75,000,000
2.625% Convertible Senior Notes due 2027 \| Convertible Debt
Debt Instrument [Line Items]
Debt instrument, face amount	$ 575,000,000
Interest rate	2.625%
Proceeds from convertible debt	$ 557,800,000
Initial conversion price (in dollars per share) \| $ / shares	$ 79.81					$ 79.81
Initial conversion premium	42.50%
Share price (in dollars per share) \| $ / shares	$ 56.01
Convertible, conversion ratio		0.0125291	0.0178539
Debt instrument, stock price percentage	130.00%
Purchase price as a percentage of principal amount	100.00%
Debt Instrument, convertible, carrying amount						$ 575,000,000
Debt instrument, unamortized discount						0
Debt instrument, fair value						575,000,000
Interest expense, debt						$ 15,100,000
Amendment 2022 Credit Facility \| Q1 2024
Debt Instrument [Line Items]
Total net leverage ratio						3.50
Minimum \| 2.625% Convertible Senior Notes due 2027 \| Convertible Debt
Debt Instrument [Line Items]
Debt instrument, covenant percentage of additional interest						0.25%
Maximum \| 2.625% Convertible Senior Notes due 2027 \| Convertible Debt
Debt Instrument [Line Items]
Debt instrument, covenant percentage of additional interest						0.50%
2019 Term Loan Facility \| Line of Credit
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity			$ 200,000,000	$ 200,000,000			$ 200,000,000
Debt instrument, term (in years)				5 years
Repayments of debt				$ 167,600,000	$ 7,800,000
Gain (loss) on extinguishment of debt				(600,000)
Deferred financing costs			2,700,000	2,700,000			2,700,000
2019 Revolving Facility \| Line of Credit
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity			200,000,000	$ 200,000,000			200,000,000
Debt instrument, term (in years)				5 years
2022 Term Facility \| Line of Credit
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity			100,000,000	$ 100,000,000			100,000,000
Revolving Credit Facility \| Line of Credit
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity			$ 350,000,000	$ 350,000,000			$ 350,000,000
Debt instrument, term (in years)				5 years
Outstanding borrowings						$ 0
Revolving Credit Facility \| Minimum \| SOFR \| Line of Credit
Debt Instrument [Line Items]
Debt instrument, basis rate						1.50%
Revolving Credit Facility \| Minimum \| Base Rate \| Line of Credit
Debt Instrument [Line Items]
Debt instrument, basis rate						0.50%
Revolving Credit Facility \| Minimum \| Leverage Ratio Range \| Line of Credit
Debt Instrument [Line Items]
Line of credit facility, unused capacity, commitment fee percentage						0.15%
Revolving Credit Facility \| Maximum \| Line of Credit
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity						$ 350,000,000
Line of credit facility, accordion feature, higher borrowing capacity option						$ 335,000,000
Revolving Credit Facility \| Maximum \| SOFR \| Line of Credit
Debt Instrument [Line Items]
Debt instrument, basis rate						2.50%
Revolving Credit Facility \| Maximum \| Base Rate \| Line of Credit
Debt Instrument [Line Items]
Debt instrument, basis rate						1.50%
Revolving Credit Facility \| Maximum \| Leverage Ratio Range \| Line of Credit
Debt Instrument [Line Items]
Line of credit facility, unused capacity, commitment fee percentage						0.35%
Letter of Credit \| Line of Credit
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity						$ 20,000,000
Bridge Loan \| Line of Credit
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity						$ 10,000,000

Acquisition of Assets	12 Months Ended
Acquisition of Assets	Dec. 31, 2023
Business Combination and Asset Acquisition [Abstract]
Acquisition of Assets	Acquisition of Assets On February 6, 2023, the Company acquired Cerveau. Cerveau holds the rights under a license agreement to develop and commercialize MK-6240, an investigational second-generation F 18-labeled positron emission tomography (“PET”) imaging agent that targets Tau tangles in Alzheimer’s disease. The Company determined that upon review of the Cerveau acquisition, the transaction did not meet the definition of a business combination and is therefore treated as an asset acquisition. In February 2023, the Company made an upfront payment of approximately $35.3 million to the stockholders of Cerveau (the “Selling Stockholders”) and paid the Selling Stockholders an additional $10.0 million in May 2023 upon the successful completion of a technology transfer. The Company could pay up to an additional $51.0 million in milestone payments upon achievement of specified U.S. regulatory milestones related to MK-6240. The Selling Stockholders are also eligible to receive up to $1.2 billion in sales milestone payments upon the achievement of specified annual commercial sales thresholds of MK-6240 in the event the Company pursues commercialization, as well as up to $13.5 million in research revenue milestones upon achievement of specified annual research revenue thresholds. Additionally, the Company will pay to the Selling Stockholders up to double-digit royalty payments for research revenue and commercial sales. Research revenue is derived from existing partnerships with pharmaceutical companies that use MK-6240 in clinical trials and includes milestone and dose-related payments. The purchase agreement pursuant to which the Company purchased Cerveau specifies, among other things, that certain members of the Selling Stockholders will also provide transition and clinical development services for a prescribed time following the closing of the transaction. In December 2022, the Company made upfront payments of $260.0 million to POINT as a part of an asset acquisition with the potential for additional milestone payments of approximately $1.8 billion between the two licensed assets based on U.S. Food and Drug Administration (“FDA”) approval and net sales and commercial milestones. Under the terms of the PNT2002 License Agreement, Lantheus Two paid POINT an upfront cash payment of $250.0 million, and could pay up to an additional $281.0 million in milestone payments upon the achievement of specified U.S. and ex-U.S. regulatory milestones related to PNT2002. POINT is also eligible to receive up to $1.3 billion in sales milestone payments upon the achievement of specified annual sales thresholds of PNT2002. Under the terms of the PNT2003 License Agreement, Lantheus Three paid POINT an upfront cash payment of $10.0 million, and could pay up to an additional $34.5 million in milestone payments upon the achievement of specified U.S. and ex-U.S. regulatory milestones related to PNT2003. POINT is also eligible to receive up to $275.0 million in sales milestone payments upon the achievement of specified annual sales thresholds of PNT2003. Additionally, the Company will pay POINT royalties on net sales, beyond certain financial thresholds and subject to conditions, of 20% for PNT2002 and 15% for PNT2003. Costs of IPR&D projects acquired as part of an asset acquisition that have no alternative future use are expensed when incurred, and therefore, a charge of $260.0 million was recognized in research and development expenses during the year ended December 31, 2022.

Leases - Schedule of Future Minimum Lease Payments (Details) $ in Thousands	Dec. 31, 2023 USD ($)
Operating Leases
2024	$ 4,624
2025	5,413
2026	7,090
2027	7,312
2028	7,453
Thereafter	67,642
Total future minimum lease payments	99,534
Less: interest	43,177
Total	56,357
Finance Leases
2024	846
2025	664
2026	151
2027	0
2028	0
Thereafter	0
Total future minimum lease payments	1,661
Less: interest	213
Finance lease liabilities	$ 1,448

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2023

Income Tax Disclosure [Abstract]

Schedule of Components of Income (loss) Before Provision (benefit) for Income Taxes

The components of income (loss) before provision (benefit) for income taxes consists of the following:


	Year Ended December 31,
(in thousands)	2023		2022		2021
U.S.	$	410,326	$	29,012	$	(76,389)
International	617		(2,293)		1,351
Income (loss) before income taxes	$	410,943	$	26,719	$	(75,038)

Schedule of Provision (benefit) for Income Taxes

The Company’s provision (benefit) for income taxes consists of the following:


	Year Ended December 31,
(in thousands)	2023		2022		2021
Current
Federal	$	110,108	$	42,532	$	—
State	29,806		4,302		(8,166)
International	—		(166)		(30)
	139,914		46,668		(8,196)
Deferred
Federal	(45,252)		(39,920)		1,048
State	(10,739)		(8,315)		3,058
International	359		219		331
	(55,632)		(48,016)		4,437
Income tax expense (benefit)	$	84,282	$	(1,348)	$	(3,759)

Schedule of Reconciliation of Income Taxes at the U.S. Federal Statutory Rate to the Actual Income Taxes

The reconciliation of income taxes at the U.S. federal statutory rate to the income tax expense (benefit) is as follows:


	Year Ended December 31,
(in thousands)	2023		2022		2021
U.S. statutory rate	$	86,298	$	5,611	$	(15,758)
Permanent items	1,042		2,309		1,764

Sale of RELISTOR licensed intangible asset associated with net sales royalties	(10,817)		—		—
Section 162(m)	307		247		1,028
Uncertain tax positions	(5,045)		(12,629)		(8,952)
Tax credits	(2,118)		(4,085)		(990)
State and local taxes	18,726		67		656
Impact on deferred taxes of change in tax rate	(330)		4,169		3,049
Changes in fair value of contingent assets and liabilities	(1,948)		5,422		15,015
Foreign tax rate differential	128		68		23
Valuation allowance	(4)		(30)		(400)
Stock compensation	(3,941)		(4,612)		(1,164)
Change in indemnification deferred tax asset	1,240		2,343		1,786
Other	744		(228)		184
Income tax expense (benefit)	$	84,282	$	(1,348)	$	(3,759)

Schedule of Components of Deferred Incomes Tax Assets (Liabilities)

The components of deferred income tax assets (liabilities) are as follows:


	December 31,
(in thousands)	2023		2022
Deferred Tax Assets
Federal benefit of state taxes payable	$	263	$	1,739
Reserves, accruals and other	18,923		31,532
Inventory obsolescence	—		919
Capitalized research and development	17,142		79,946
Stock compensation	9,266		—
Intangible assets	25,214		—
Net operating loss carryforwards	80,184		88,014
Lease liability	14,365		—
Deferred tax assets	165,357		202,150
Deferred Tax Liabilities
Reserves, accruals and other	—		(5,354)
Right-of-use asset	(11,543)		—
Intangible assets	—		(80,770)
Amortization of intangibles other than goodwill	—		(385)
Depreciation	—		(1,469)
Deferred tax liability	(11,543)		(87,978)
Less: valuation allowance	(3,616)		(3,525)
	$	150,198	$	110,647
Recorded in the accompanying consolidated balance sheets as:
Noncurrent deferred tax assets, net	$	150,198	$	110,647

Schedule of Reconciliation of the Company's Changes in Uncertain Tax Positions

A reconciliation of the Company’s changes in uncertain tax positions for 2023 and 2022 is as follows:


(in thousands)	Amount
Balance of uncertain tax positions as of January 1, 2021	$	5,292
Additions related to current year tax positions	—
Reductions related to prior year tax positions	(188)
Settlements	(1,446)
Lapse of statute of limitations	—
Balance of uncertain tax positions as of December 31, 2021	3,658
Additions related to current year tax positions	—
Reductions related to prior year tax positions	(1,180)
Settlements	(306)
Lapse of statute of limitations	(692)
Balance of uncertain tax positions as of December 31, 2022	1,480
Additions related to current year tax positions	3,749
Reductions related to prior year tax positions	(688)
Settlements	(442)
Lapse of statute of limitations	—
Balance of uncertain tax positions as of December 31, 2023	$	4,099

Long-Term Debt, Net, and Other Borrowings (Tables)

12 Months Ended

Dec. 31, 2023

Debt Disclosure [Abstract]

Schedule of Maturities of Principal Obligations

As of December 31, 2023, the Company’s maturities of principal obligations under its long-term debt and other borrowings are as follows:


(in thousands)	Amount
2024	$	—
2025	—
2026	—
2027	575,000
2028	—
Total principal outstanding	575,000

Unamortized debt issuance costs	(13,955)
Finance lease liabilities	1,448
Total	562,493
Less: current portion	(823)
Total long-term debt, net, and other borrowings	$	561,670

Leases - Schedule of Operating and Financing Lease Assets and Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Assets
Operating lease, right-of-use asset	$ 45,325	$ 19,033
Finance	1,438	582
Total leased assets	$ 46,763	$ 19,615
Operating lease, right-of-use asset, statement of financial position [Extensible List]	Other long-term assets	Other long-term assets
Finance lease, right-of-use asset, statement of financial position [Extensible List]	Property, plant and equipment, net	Property, plant and equipment, net
Current
Operating	$ 1,904	$ 2,177
Finance	823	354
Noncurrent
Operating	54,453	25,442
Finance	625	231
Total leased liabilities	$ 57,805	$ 28,204
Operating lease, liability, current, statement of financial position [Extensible List]	Accrued expenses and other liabilities	Accrued expenses and other liabilities
Finance lease, liability, current, statement of financial position [Extensible List]	Current portion of long-term debt and other borrowings	Current portion of long-term debt and other borrowings
Operating lease, liability, noncurrent, statement of financial position [Extensible List]	Other long-term liabilities	Other long-term liabilities
Finance lease, liability, noncurrent, statement of financial position [Extensible List]	Total long-term debt, net, and other borrowings	Total long-term debt, net, and other borrowings

Insider Trading Arrangements	3 Months Ended	12 Months Ended
Insider Trading Arrangements	Dec. 31, 2023 shares	Dec. 31, 2023 shares
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	true
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false
Sam Leno [Member]
Trading Arrangements, by Individual
Material Terms of Trading Arrangement		On November 7, 2023, Sam Leno, a member of our Board, entered into a trading plan intended to satisfy the affirmative defense conditions of Rule 10b5-1(c) under the Exchange Act (a “10b5-1 Plan”), providing for the potential sale of up to 2,045 shares of our common stock obtained from the exercise of vested stock options covered by the 10b5-1 Plan, between March 4, 2024 and May 15, 2024. On November 29, 2023, Mr. Leno amended his 10b5-1 Plan to add the potential sale of up to 20,344 additional shares of our common stock obtained from the exercise of vested stock options covered by the 10b5-1 Plan, between March 4, 2024 and May 15, 2024.
Name	Sam Leno
Title	member of our Board
Adoption Date	November 7, 2023
Arrangement Duration	72 days
Aggregate Available	2,045	2,045
Amended 10b5-1 Plan [Member] \| Sam Leno [Member]
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	November 29, 2023
Arrangement Duration	72 days
Aggregate Available	20,344	20,344

Stock-Based Compensation (Tables)

12 Months Ended

Dec. 31, 2023

Share-Based Payment Arrangement [Abstract]

Schedule of Stock-Based Compensation Expense Recognized

Stock-based compensation expense recognized in the consolidated statements of operations is summarized below:


	Year Ended December 31,
(in thousands)	2023		2022		2021
Cost of goods sold	$	9,126	$	4,422	$	2,370
Sales and marketing	9,500		6,185		2,472
General and administrative	24,807		14,876		9,092
Research and development	7,074		3,779		2,000
Total stock-based compensation expense	$	50,507	$	29,262	$	15,934

Schedule of Option Activity

A summary of option activity for 2023 is presented below:


	Total Stock Options	Weighted- Average Exercise Price		Weighted- Average Remaining Contractual Term (Years)	Aggregate Intrinsic Value
Balance at January 1, 2023	874,749	$	30.37	5.8	19,058,224
Options granted	332,368	$	76.41
Options exercised	(214,619)	$	19.02
Options cancelled and forfeited	(35,326)	$	51.30
Outstanding at December 31, 2023	957,172	$	48.13	6.7	18,283,464
Vested and expected to vest at December 31, 2023	957,172	$	48.13	6.7	18,283,464
Exercisable at December 31, 2023	466,039	$	26.99	4.4	16,462,767

Schedule of Valuation Model

The table below summarizes the key weighted-average assumptions used in valuing stock options granted:


	Year Ended December 31,
	2023		2022		2021
Expected volatility	56.1	%	62.1	%	—	%
Risk-free interest rate	4.0	%	2.0	%	—	%
Expected life (in years)	6.0		6.0		—
Expected dividend yield	—		—		—

Schedule of Restricted Stock Awards Activity

A summary of restricted stock awards and restricted stock units activity for 2023 is presented below:


	Shares	Weighted- Average Grant Date Fair Value Per Share
Nonvested balance at January 1, 2023	1,249,992	$	34.65
Granted	710,985	$	74.38
Vested	(612,912)	$	29.78
Forfeited	(137,806)	$	50.36
Nonvested balance at December 31, 2023	1,210,259	$	58.71

A summary of TSR Award activity for 2023 is presented below:


	Shares	Weighted- Average Grant Date Fair Value Per Share
Nonvested balance at January 1, 2023	658,875	$	48.58
Granted	365,478	$	127.75
Vested	(348,302)	$	23.43
Forfeited	(45,997)	$	57.77
Nonvested balance at December 31, 2023	630,054	$	78.91

Schedule of RSU Valuation Model

The fair value of these awards are based on a Monte Carlo simulation valuation model with the following assumptions:


	Year Ended December 31,
	2023		2022		2021
Expected volatility	52.8	%	56.6	%	54.0	%
Risk-free interest rate	4.6	%	1.7	%	30.0	%
Expected life (in years)	2.8		2.8		2.8
Expected dividend yield	—		—		—

Summary of Significant Accounting Policies - Stock Based Compensation (Details)	12 Months Ended
	Dec. 31, 2023
Accounting Policies [Abstract]
Expected dividend yield	0.00%

Sale of Puerto Rico Subsidiary	12 Months Ended
Sale of Puerto Rico Subsidiary	Dec. 31, 2023
Discontinued Operations and Disposal Groups [Abstract]
Sale of Puerto Rico Subsidiary	Sale of Puerto Rico Subsidiary During the fourth quarter of 2020, the Company entered into a stock purchase agreement (the “SPA”) with one of its existing radiopharmacy customers to sell all the stock of its Puerto Rico radiopharmacy subsidiary. The assets were classified as held for sale and the Company determined that the fair value of the net assets being sold significantly exceeded the carrying value as of December 31, 2020. The transaction was consummated on January 29, 2021. The purchase price for the stock sale was $18.0 million in cash, which included a holdback amount of $1.8 million that was remitted to the Company as of December 31, 2021, and paid in the first quarter of 2022; the purchase price also included a working capital adjustment. The SPA contained customary representations, warranties and covenants by each of the parties. Subject to certain limitations, the buyer will be indemnified for damages resulting from breaches or inaccuracies of the Company’s representations, warranties and covenants in the SPA. The Company determined that this sale of certain net assets did not constitute a strategic shift that had a major effect on the Company’s operations or financial results. As a result, this transaction was not classified as discontinued operations in the Company’s accompanying consolidated financial statements. The sale resulted in a pre-tax book gain of $15.3 million, which was recorded within operating income (loss) in the consolidated statements of operations for the year ended December 31, 2021.

Segment Information	12 Months Ended
Segment Information	Dec. 31, 2023
Segment Reporting [Abstract]
Segment Information	Segment Information The Company operates as one business segment. The results of this operating segment are regularly reviewed by the Company’s chief operating decision maker, the Chief Executive Officer. The Company’s chief operating decision maker does not manage any part of the Company separately, and the allocation of resources and assessment of performance are based on the Company’s consolidated operating results.

- Definition

The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 22
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-22

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 15
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-15

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 31
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-31

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 32
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-32

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 42
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-42

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 32
-Subparagraph (f)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-32

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 40
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-40

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org//280/tableOfContent

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 26
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-26

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 34
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-34

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 41
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-41

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 21
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-21

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 21
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-21

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 32
-Subparagraph (e)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-32

+ Details

Summary of Significant Accounting Policies - Schedule of Estimated Useful Lives (Details)	Dec. 31, 2023
Buildings \| Minimum
Property, Plant & Equipment [Line Items]
Estimated useful lives	10 years
Buildings \| Maximum
Property, Plant & Equipment [Line Items]
Estimated useful lives	50 years
Land improvements \| Minimum
Property, Plant & Equipment [Line Items]
Estimated useful lives	15 years
Land improvements \| Maximum
Property, Plant & Equipment [Line Items]
Estimated useful lives	40 years
Machinery and equipment \| Minimum
Property, Plant & Equipment [Line Items]
Estimated useful lives	3 years
Machinery and equipment \| Maximum
Property, Plant & Equipment [Line Items]
Estimated useful lives	15 years
Furniture and fixtures
Property, Plant & Equipment [Line Items]
Estimated useful lives	15 years
Leasehold improvements
Property, Plant & Equipment [Line Items]
Estimated useful lives	15 years
Computer software \| Minimum
Property, Plant & Equipment [Line Items]
Estimated useful lives	3 years
Computer software \| Maximum
Property, Plant & Equipment [Line Items]
Estimated useful lives	5 years

Asset Retirement Obligations - Additional Information (Details) $ in Millions	Dec. 31, 2023 USD ($)
Asset Retirement Obligation Disclosure [Abstract]
Obligation expected to be incurred	$ 25.1
Financial assurance in form of surety bond	$ 30.3

Income Taxes

12 Months Ended

Dec. 31, 2023

Income Tax Disclosure [Abstract]

Income Taxes

The components of income (loss) before provision (benefit) for income taxes consists of the following:


	Year Ended December 31,
(in thousands)	2023		2022		2021
U.S.	$	410,326	$	29,012	$	(76,389)
International	617		(2,293)		1,351
Income (loss) before income taxes	$	410,943	$	26,719	$	(75,038)

The Company’s provision (benefit) for income taxes consists of the following:


	Year Ended December 31,
(in thousands)	2023		2022		2021
Current
Federal	$	110,108	$	42,532	$	—
State	29,806		4,302		(8,166)
International	—		(166)		(30)
	139,914		46,668		(8,196)
Deferred
Federal	(45,252)		(39,920)		1,048
State	(10,739)		(8,315)		3,058
International	359		219		331
	(55,632)		(48,016)		4,437
Income tax expense (benefit)	$	84,282	$	(1,348)	$	(3,759)

The reconciliation of income taxes at the U.S. federal statutory rate to the income tax expense (benefit) is as follows:


	Year Ended December 31,
(in thousands)	2023		2022		2021
U.S. statutory rate	$	86,298	$	5,611	$	(15,758)
Permanent items	1,042		2,309		1,764

Sale of RELISTOR licensed intangible asset associated with net sales royalties	(10,817)		—		—
Section 162(m)	307		247		1,028
Uncertain tax positions	(5,045)		(12,629)		(8,952)
Tax credits	(2,118)		(4,085)		(990)
State and local taxes	18,726		67		656
Impact on deferred taxes of change in tax rate	(330)		4,169		3,049
Changes in fair value of contingent assets and liabilities	(1,948)		5,422		15,015
Foreign tax rate differential	128		68		23
Valuation allowance	(4)		(30)		(400)
Stock compensation	(3,941)		(4,612)		(1,164)
Change in indemnification deferred tax asset	1,240		2,343		1,786
Other	744		(228)		184
Income tax expense (benefit)	$	84,282	$	(1,348)	$	(3,759)

The components of deferred income tax assets (liabilities) are as follows:


	December 31,
(in thousands)	2023		2022
Deferred Tax Assets
Federal benefit of state taxes payable	$	263	$	1,739
Reserves, accruals and other	18,923		31,532
Inventory obsolescence	—		919
Capitalized research and development	17,142		79,946
Stock compensation	9,266		—
Intangible assets	25,214		—
Net operating loss carryforwards	80,184		88,014
Lease liability	14,365		—
Deferred tax assets	165,357		202,150
Deferred Tax Liabilities
Reserves, accruals and other	—		(5,354)
Right-of-use asset	(11,543)		—
Intangible assets	—		(80,770)
Amortization of intangibles other than goodwill	—		(385)
Depreciation	—		(1,469)
Deferred tax liability	(11,543)		(87,978)
Less: valuation allowance	(3,616)		(3,525)
	$	150,198	$	110,647
Recorded in the accompanying consolidated balance sheets as:
Noncurrent deferred tax assets, net	$	150,198	$	110,647

The Tax Cuts and Jobs Act (the “Act”) was enacted on December 22, 2017. Under the Act, research and experimental expenditures incurred for tax years beginning after December 31, 2021, must be capitalized and amortized ratably over five or fifteen years for tax purposes, depending on where the research activities are conducted. If the requirement to capitalize Section 174 expenditures is not modified, it may impact our cash tax liability in future years. The increase in worldwide net deferred tax assets is primarily due to the tax capitalization of the Company’s current year research and development expenses that are not currently deductible in 2023 and the decrease in deferred tax liabilities related to the AZEDRA and RELISTOR royalty intangible assets, partially offset by utilization of net operating losses.

The Company regularly assesses its ability to realize its deferred tax assets. Assessing the realizability of deferred tax assets requires significant management judgment. In determining whether its deferred tax assets are more-likely-than-not realizable, the Company evaluated all available positive and negative evidence. As of December 31, 2023 and 2022, the Company maintains a valuation allowance of $3.6 million and $3.5 million, respectively, primarily related to net deferred tax assets of certain of its foreign subsidiaries.

Utilization of net operating loss carryforwards and research and development credit carryforwards may be subject to a substantial annual limitation due to ownership change limitations that could occur in the future in accordance with Section 382 of the Internal Revenue Code of 1986 (“IRC Section 382”) and with Section 383 of the Internal Revenue Code of 1986, as well as similar state provisions. These ownership changes may limit the amount of net operating loss carryforwards and research and development credit carryforwards that can be utilized annually to offset future taxable income and taxes, respectively. In general, an ownership change, as defined by IRC Section 382, results from transactions which impact the ownership of certain stockholders or public groups in the stock of a corporation by more than 50 percentage points over a three-year period.

At December 31, 2023, the Company had U.S. federal net operating loss carryforwards of approximately $297.6 million, $157.9 million of which will expire between 2027 and 2037, and $139.6 million of which can be carried forward indefinitely. The Company’s state net operating losses are $12.5 million on a tax-effected basis, which will expire between 2024 and 2040. The Company has state research credit carryforwards of $2.1 million, which will expire between 2026 and 2038. The Company has state investment tax credit carryforwards of $0.8 million which have no expiration date.

The Company’s U.S. federal income tax returns are subject to examination for three years after the filing date of the return. The state and foreign income tax returns are subject to examination for periods varying from three to four years after filing, depending on the specific jurisdiction’s statutes of limitation, and in the case of Sweden, up to six years after the end of the financial year.

A reconciliation of the Company’s changes in uncertain tax positions for 2023 and 2022 is as follows:


(in thousands)	Amount
Balance of uncertain tax positions as of January 1, 2021	$	5,292
Additions related to current year tax positions	—
Reductions related to prior year tax positions	(188)
Settlements	(1,446)
Lapse of statute of limitations	—
Balance of uncertain tax positions as of December 31, 2021	3,658
Additions related to current year tax positions	—
Reductions related to prior year tax positions	(1,180)
Settlements	(306)
Lapse of statute of limitations	(692)
Balance of uncertain tax positions as of December 31, 2022	1,480
Additions related to current year tax positions	3,749
Reductions related to prior year tax positions	(688)
Settlements	(442)
Lapse of statute of limitations	—
Balance of uncertain tax positions as of December 31, 2023	$	4,099

In connection with the Company’s acquisition of the medical imaging business from Bristol-Myers Squibb (“BMS”) in 2008, the Company recorded a liability for uncertain tax positions related to the acquired business and simultaneously entered into an indemnification agreement with BMS for any payments made to settle those uncertain tax positions with the taxing authorities.

In accordance with the Company’s accounting policy, the change in the tax liability, penalties and interest associated with these obligations (net of any offsetting federal or state benefit) is recognized within income tax expense. As these reserves change, adjustments are included in income tax expense while the offsetting adjustment is included in other income. Assuming that the receivable from BMS continues to be considered recoverable by the Company, there will be no effect on net income and no net cash outflows related to these liabilities. Included in other (income) loss for the years ended December 31, 2023, 2022 and 2021, is tax indemnification expense (income), net of $4.9 million, $9.6 million and $7.1 million, respectively.

As of December 31, 2023 and 2022, total liabilities for uncertain tax positions including interest and penalties were $5.4 million and $8.3 million, respectively, consisting of uncertain tax positions of $4.1 million and $1.5 million, respectively, interest accruals of $1.3 million and $6.4 million, respectively, and no penalty accruals as of December 31, 2023 and $0.4 million of penalty accruals as of December 31, 2022. The increase in uncertain tax positions during the year ended December 31, 2023 was primarily related to certain acquired tax attributes. As of December 31, 2023, $1.3 million, $3.2 million, and $0.9 million of these liabilities were recorded in current liabilities, other long-term liabilities, and as a reduction of deferred tax assets, respectively. As of December 31, 2022 these liabilities were included in other long-term liabilities. Included in the 2023, 2022 and 2021 tax provisions are benefits of $5.0 million, $12.6 million and $9.0 million, respectively, relating to reversals of uncertain tax positions recognized upon settlements, effective settlements, or lapses of relevant statutes of limitation, partially offset by interest accruals.

- Definition

The entire disclosure for income taxes. Disclosures may include net deferred tax liability or asset recognized in an enterprise's statement of financial position, net change during the year in the total valuation allowance, approximate tax effect of each type of temporary difference and carryforward that gives rise to a significant portion of deferred tax liabilities and deferred tax assets, utilization of a tax carryback, and tax uncertainties information.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480990/946-20-50-13

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(h)(2))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-1

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org//740/tableOfContent

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 14
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482685/740-10-50-14

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 21
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482685/740-10-50-21

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 270
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482526/740-270-50-1

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 17
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482685/740-10-50-17

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SAB TOPIC 6.I.5.Q1)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479360/740-10-S99-1

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 2
-Subparagraph (SAB Topic 11.C)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479360/740-10-S99-2

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 30
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482603/740-30-50-2

+ Details

Income Taxes - Schedule of Differences in Statutory Rate and Effective Rate (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Tax Disclosure [Abstract]
U.S. statutory rate	$ 86,298	$ 5,611	$ (15,758)
Permanent items	1,042	2,309	1,764
Sale of RELISTOR licensed intangible asset associated with net sales royalties	(10,817)	0	0
Section 162(m)	307	247	1,028
Uncertain tax positions	(5,045)	(12,629)	(8,952)
Tax credits	(2,118)	(4,085)	(990)
State and local taxes	18,726	67	656
Impact on deferred taxes of change in tax rate	(330)	4,169	3,049
Changes in fair value of contingent assets and liabilities	(1,948)	5,422	15,015
Foreign tax rate differential	128	68	23
Valuation allowance	(4)	(30)	(400)
Stock compensation	(3,941)	(4,612)	(1,164)
Change in indemnification deferred tax asset	1,240	2,343	1,786
Other	744	(228)	184
Income tax expense (benefit)	$ 84,282	$ (1,348)	$ (3,759)

Leases

12 Months Ended

Dec. 31, 2023

Leases [Abstract]

Leases

The Company determines if an arrangement is a lease at inception. The Company has operating and finance leases for vehicles, corporate offices and certain equipment.

Operating lease right-of-use (“ROU”) assets and operating lease liabilities are recognized based on the present value of the future minimum lease payments over the lease term at commencement date. Lease agreements with lease and non-lease components are accounted for separately. As the Company’s leases do not provide an implicit rate, the Company used the incremental borrowing rate based on the information available at commencement date in determining the present value of future payments. The operating lease ROU asset also includes any lease payments made and excludes lease incentives and initial direct costs incurred. The lease terms may include options to extend or terminate the lease when it is reasonably certain that the Company will exercise that option. Lease expense for minimum lease payments is recognized on a straight-line basis over the lease term.

The Company assumed two operating leases as a result of the Progenics acquisition related to office space at the World Trade Center in New York City, pursuant to a lease agreement expiring in September 2030 (the “WTC Lease”), and a radiopharmaceutical manufacturing facility in Somerset, New Jersey, under a sublease agreement expiring in November 2028, which were recorded as of June 19, 2020, for $18.6 million and $0.6 million, respectively. The Company entered into an operating lease related to office space in Somerset, New Jersey, under a lease agreement expiring in August 2026, which was recorded in October 2021 for $0.7 million. The Company entered into an operating lease agreement in February 2022 to lease office space in Bedford, Massachusetts, under a lease agreement expiring in June 2031, which commenced and was recorded in December 2022 for $11.0 million.

On May 4, 2023, the Company entered into a modification to the operating lease for office space in Bedford, Massachusetts, (the “Existing Premises”) that was executed in February 2022. The lease commenced and was recorded in December 2022 for $11.0 million and the initial term was set to expire in June 2031. The lease modification includes a lease of additional office and laboratory space at the Bedford location (the “Additional Premises”) for a term of 15 years and 4 months and extends the term of the lease for the Existing Premises to be coterminous with the term of the lease for the Additional Premises. As a result of the extended term for the Existing Premises, the Company recorded an additional right-of-use asset and liability of $6.0 million in May 2023. The modification also contains a provision to convert the rent schedule of the Existing Premises from gross to triple net in 2024, which may result in an additional adjustment to the right-of-use asset and liability. In September 2023, the landlord provided notice to the Company that its renovations of the Additional Premises were completed. As a result of the notice, the Company recorded an additional right-of-use asset and liability of $23.5 million as of September 1, 2023. To determine the value of the additional right-of-use asset and liability, the Company was required to calculate the discount rate of the lease modification. The discount rate was determined based on the expected lease term and by comparing interest rates in the market for similar borrowings with comparable credit quality of the Company. The lease for the Additional Premises allows for the extension of five years to begin immediately upon the expiration of the original term.

Leases with an initial term of 12 months or less are not recorded on the balance sheet as the Company has elected to apply the short-term lease exemption. The Company recognizes lease expense for these leases on a straight-line basis over the lease term.

Operating and finance lease assets and liabilities are as follows:


(in thousands)	Classification	December 31, 2023		December 31, 2022
Assets
Operating	Other long-term assets	$	45,325	$	19,033
Finance	Property, plant and equipment, net	1,438		582
Total leased assets		$	46,763	$	19,615
Liabilities
Current
Operating	Accrued expenses and other liabilities	$	1,904	$	2,177
Finance	Current portion of long-term debt and other borrowings	823		354
Noncurrent
Operating	Other long-term liabilities	54,453		25,442
Finance	Long-term debt, net and other borrowings	625		231
Total leased liabilities		$	57,805	$	28,204

In the third quarter of 2021, with respect to the office space in the World Trade Center, the Company negotiated a sublease agreement with an unrelated third party that was signed on October 11, 2021 (the “Sublease”) and has a term of nine years, which represents the remaining term of the WTC Lease. Both the WTC Lease and the Sublease are classified by the Company as operating leases. As a result of the negotiations of the Sublease, the Company determined that an impairment triggering event had occurred. Accordingly, the Company performed an undiscounted cash flow analysis related to the asset group as of September 30, 2021. Based on the undiscounted cash flow analysis, the Company determined that the asset group, including the ROU asset, had net carrying values that exceeded their estimated undiscounted future cash flows. The Company then estimated the fair value of the asset group based on its discounted cash flows. The carrying value exceeded the fair value and, as a result, the Company recorded a non-cash impairment of $9.5 million for the year ended December 31, 2021 in general and administrative expenses in the consolidated statements of operations.

The components of lease expense were as follows:


(in thousands)	Year Ended December 31, 2023		Year Ended December 31, 2022
Operating lease expense	$	4,627	$	1,797
Finance lease expense
Amortization of ROU assets	795		426
Interest on lease liabilities	81		28

Total lease expense	$	5,503	$	2,251

Other information related to leases were as follows:


		December 31, 2023		December 31, 2022
Weighted-average remaining lease term (Years):
Operating leases		13.5		7.9
Finance leases		2.3		1.9
Weighted-average discount rate:
Operating leases		7.3%		4.8%
Finance leases		6.2%		4.4%

(in thousands)		Year Ended December 31, 2023		Year Ended December 31, 2022
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$	3,462	$	2,440
Operating cash flows from finance leases		81		28
Financing cash flows from finance leases		504		384
ROU assets obtained in exchange for lease obligations:
Operating leases		29,396		11,019
Finance leases		1,437		582

Future minimum lease payments under non-cancellable leases as of December 31, 2023 were as follows:


(in thousands)	Operating Leases		Finance Leases
2024	$	4,624	$	846
2025	5,413		664
2026	7,090		151
2027	7,312		—
2028	7,453		—
Thereafter	67,642		—
Total future minimum lease payments	99,534		1,661
Less: interest	43,177		213
Total	$	56,357	$	1,448

Leases

The Company determines if an arrangement is a lease at inception. The Company has operating and finance leases for vehicles, corporate offices and certain equipment.

Operating and finance lease assets and liabilities are as follows:


(in thousands)	Classification	December 31, 2023		December 31, 2022
Assets
Operating	Other long-term assets	$	45,325	$	19,033
Finance	Property, plant and equipment, net	1,438		582
Total leased assets		$	46,763	$	19,615
Liabilities
Current
Operating	Accrued expenses and other liabilities	$	1,904	$	2,177
Finance	Current portion of long-term debt and other borrowings	823		354
Noncurrent
Operating	Other long-term liabilities	54,453		25,442
Finance	Long-term debt, net and other borrowings	625		231
Total leased liabilities		$	57,805	$	28,204

The components of lease expense were as follows:


(in thousands)	Year Ended December 31, 2023		Year Ended December 31, 2022
Operating lease expense	$	4,627	$	1,797
Finance lease expense
Amortization of ROU assets	795		426
Interest on lease liabilities	81		28

Total lease expense	$	5,503	$	2,251

Other information related to leases were as follows:


		December 31, 2023		December 31, 2022
Weighted-average remaining lease term (Years):
Operating leases		13.5		7.9
Finance leases		2.3		1.9
Weighted-average discount rate:
Operating leases		7.3%		4.8%
Finance leases		6.2%		4.4%

(in thousands)		Year Ended December 31, 2023		Year Ended December 31, 2022
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$	3,462	$	2,440
Operating cash flows from finance leases		81		28
Financing cash flows from finance leases		504		384
ROU assets obtained in exchange for lease obligations:
Operating leases		29,396		11,019
Finance leases		1,437		582

Future minimum lease payments under non-cancellable leases as of December 31, 2023 were as follows:


(in thousands)	Operating Leases		Finance Leases
2024	$	4,624	$	846
2025	5,413		664
2026	7,090		151
2027	7,312		—
2028	7,453		—
Thereafter	67,642		—
Total future minimum lease payments	99,534		1,661
Less: interest	43,177		213
Total	$	56,357	$	1,448

Summary of Significant Accounting Policies - Advertising and Promotion Costs (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Accounting Policies [Abstract]
Advertising and promotion costs	$ 26.0	$ 26.0	$ 17.5

Leases - Schedule of Components of Lease Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Leases [Abstract]
Operating lease expense	$ 4,627	$ 1,797
Finance lease expense
Amortization of ROU assets	795	426
Interest on lease liabilities	81	28
Total lease expense	$ 5,503	$ 2,251

Revenue from Contracts with Customers (Tables)

12 Months Ended

Dec. 31, 2023

Revenue from Contract with Customer [Abstract]

Schedule of Disaggregation of Revenue

The following table summarizes revenue by revenue source as follows:


	Year Ended December 31,
Major Products/Service Lines (in thousands)	2023		2022		2021
Product revenue, net(1)	$	1,263,068	$	887,038	$	400,356
License and royalty revenues(2)	33,361		48,023		24,852
Total revenues	$	1,296,429	$	935,061	$	425,208

______________________________

(1)The Company’s product revenue includes PYLARIFY and DEFINITY, among other products. This category represents the delivery of physical goods. The Company applies the same revenue recognition policies and judgments for all of its principal products.

(2)The Company recognized $24.0 million license revenue in the first quarter of 2022 related to an agreement with Novartis Pharma AG.

Revenue by product category on a net basis is as follows:


	Year Ended December 31,
(in thousands)	2023		2022		2021
PYLARIFY	$	851,303	$	527,405	$	43,414
Other radiopharmaceutical oncology	3,130		4,102		5,473
Total radiopharmaceutical oncology	854,433		531,507		48,887
DEFINITY	279,768		244,993		232,759
TechneLite	87,370		88,864		91,293
Other precision diagnostics	22,980		22,825		26,973
Total precision diagnostics	390,118		356,682		351,025
Strategic Partnerships and other revenue	51,878		46,872		25,296
Total revenues	$	1,296,429	$	935,061	$	425,208

Schedule of Valuation and Qualifying Accounts

An analysis of the amount of, and change in, reserves is summarized as follows:


(in thousands)	Rebates and Allowances
Balance, January 1, 2022	$	10,977
Provision related to current period revenues	26,683
Adjustments relating to prior period revenues	70
Payments or credits made during the period	(24,331)
Balance, December 31, 2022	13,399
Provision related to current period revenues	32,308
Adjustments relating to prior period revenues	(453)
Payments or credits made during the period	(29,184)
Balance, December 31, 2023	$	16,070

Schedule of contracts with customer

The Company recognized certain revenues as follows:


	Year Ended December 31,
(in thousands)	2023		2022
Amounts included in the contract liability at the beginning of the period	$	682	$	244

Stock-Based Compensation - Stock Options Narrative (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Share-Based Payment Arrangement [Abstract]
Options exercised (in shares)	214,619	397,822	318,662
Aggregate intrinsic value	$ 12.9	$ 13.1	$ 1.6
Unrecognized compensation expense	$ 13.2
Weighted-average remaining period for recognition of unrecognized compensation costs	2 years

Segment Information (Details)	12 Months Ended
Segment Information (Details)	Dec. 31, 2023 Segment
Segment Reporting [Abstract]
Number of operating segments	1

Accrued Expenses and Other Liabilities and Other Long-Term Liabilities (Tables)

12 Months Ended

Dec. 31, 2023

Payables and Accruals [Abstract]

Schedule of Accrued Expenses

Accrued expenses and other liabilities and other long-term liabilities are comprised of the following:


	December 31,
(in thousands)	2023		2022
Compensation and benefits	$	36,331	$	30,425
Freight, distribution and operations	67,529		49,067
Accrued rebates, discounts and chargebacks	16,070		13,399
Accrued professional fees	10,244		8,668

Other	15,164		25,525
Total accrued expenses and other liabilities	$	145,338	$	127,084

Operating lease liabilities (Note 16)	$	54,453	$	25,442
Long-term contingent liability (Note 4)	2,700		11,900
Other long-term liabilities	6,168		8,813
Total other long-term liabilities	$	63,321	$	46,155

Fair Value of Financial Instruments (Tables)

12 Months Ended

Dec. 31, 2023

Fair Value Disclosures [Abstract]

Schedule of Assets and Liabilities Measured at Fair Value on a Recurring Basis

The tables below present information about the Company’s assets and liabilities measured at fair value on a recurring basis:


	December 31, 2023
(in thousands)	Total Fair Value		Level 1		Level 2		Level 3
Assets:
Money market funds	$	574,131	$	574,131	$	—	$	—


Total assets	$	574,131	$	574,131	$	—	$	—
Liabilities:

Contingent consideration liabilities	$	2,700	$	—	$	—	$	2,700
Total liabilities	$	2,700	$	—	$	—	$	2,700


	December 31, 2022
(in thousands)	Total Fair Value		Level 1		Level 2		Level 3
Assets:
Money market funds	$	342,646	$	342,646	$	—	$	—


Total assets	$	342,646	$	342,646	$	—	$	—
Liabilities:

Contingent consideration liabilities	$	111,600	$	—	$	—	$	111,600
Total liabilities	$	111,600	$	—	$	—	$	111,600

Fair Value Measurement Inputs and Valuation Techniques

The following tables summarize quantitative information and assumptions pertaining to the fair value measurement of liabilities using Level 3 inputs as of December 31, 2023.


	Fair Value as of						Assumptions
(in thousands)	December 31, 2023		December 31, 2022		Valuation Technique	Unobservable Input	December 31, 2023		December 31, 2022
Contingent consideration liability:
Net sales targets – PYLARIFY (CVRs)	N/A		$	99,700	Probability adjusted discounted cash flow model	Period of expected milestone achievement and sales targets	N/A		2022 – 2023
						Probability of success	N/A		100	%

1095 commercialization milestone	1,800		1,700		Probability adjusted discounted cash flow model
						Period of expected milestone achievement	2026		2026
						Probability of success	40	%	40	%
						Discount rate	4.1	%	3.8	%



Net sales targets – AZEDRA and 1095	900		10,200		Monte Carlo simulation
						Probability of success and sales targets	0% - 40%		20% - 100%
						Discount rate	15%		16% - 17%
Total	$	2,700	$	111,600

Schedule of Financial Instruments with Significant Level 3 Inputs

For those financial instruments with significant Level 3 inputs, the following table summarizes the activities for the periods indicated:


	Financial Assets				Financial Liabilities
(in thousands)	Years Ended December 31,				Years Ended December 31,
	2023		2022		2023		2022
Fair value, beginning of period	$	—	$	9,300	$	111,600	$	86,200

Changes in fair value included in net income (loss)	—		(9,300)		(9,275)		25,400
Cash Payments	—		—		(99,625)		—

Fair value, end of period	$	—	$	—	$	2,700	$	111,600

Commitments and Contingencies - Schedule of Purchase Commitments Under Noncancelable Arrangements (Details) $ in Thousands	Dec. 31, 2023 USD ($)
Commitments and Contingencies Disclosure [Abstract]
2024	$ 2,716
2025	2,716
2026	2,716
2027	2,716
2028 and thereafter	0
Total	$ 10,864

Income Taxes - Additional Information (Details) - USD ($)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Operating Loss Carryforwards [Line Items]
Deferred tax asset, valuation allowance	$ 3,616,000	$ 3,525,000
Indemnification expense	4,943,000	9,554,000	$ 7,121,000
Total liabilities for uncertain tax positions including interest and penalties	5,400,000	8,300,000
Uncertain tax positions	4,099,000	1,480,000	3,658,000	$ 5,292,000
Interest accruals	1,300,000	6,400,000
Penalty accruals	0	400,000
Tax provision benefit/expense	5,045,000	$ 12,629,000	$ 8,952,000
Liabilities, Current
Operating Loss Carryforwards [Line Items]
Total liabilities for uncertain tax positions including interest and penalties	1,300,000
Other Noncurrent Liabilities
Operating Loss Carryforwards [Line Items]
Total liabilities for uncertain tax positions including interest and penalties	3,200,000
Deferred Income Tax Assets, Net
Operating Loss Carryforwards [Line Items]
Total liabilities for uncertain tax positions including interest and penalties	900,000
Federal
Operating Loss Carryforwards [Line Items]
Net operating loss carryovers	297,600,000
Operating loss carryforwards expire	157,900,000
Operating loss carried forward	139,600,000
State Research Credit
Operating Loss Carryforwards [Line Items]
Net operating loss carryovers	12,500,000
Tax credits	2,100,000
Massachusetts \| Investment Tax Credit Carryforward
Operating Loss Carryforwards [Line Items]
Tax credits	$ 800,000

Intangibles, Net and Goodwill - Additional Information (Details) - USD ($) $ in Thousands		1 Months Ended			3 Months Ended	12 Months Ended
	Aug. 02, 2023	May 31, 2023	Feb. 28, 2023	May 31, 2021	Dec. 31, 2023	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Indefinite-lived Intangible Assets [Line Items]
Amortization expense						$ 46,400	$ 33,200	$ 27,500
Proceeds from selling rights to the royalties	$ 98,000
Gain on sale of RELISTOR licensed intangible asset associated with net sales royalties	5,000
Accumulated amortization					$ 176,983	176,983	174,476
Gain on sales of assets						51,789	0	15,263
Revenues						1,296,429	935,061	$ 425,208
License and Royalty Revenues, Sales-Based Milestone Payment
Indefinite-lived Intangible Assets [Line Items]
Revenues					15,000
Cerveau Technologies, Inc
Indefinite-lived Intangible Assets [Line Items]
Payment for acquisitions		$ 10,000	$ 35,300
Asset acquisition, consideration transferred		$ 10,000
Research and development
Indefinite-lived Intangible Assets [Line Items]
Impairment						$ 15,600
Impairment, Intangible Asset, Indefinite-Lived (Excluding Goodwill), Statement of Income or Comprehensive Income [Extensible Enumeration]						Research and development
Cost of goods sold
Indefinite-lived Intangible Assets [Line Items]
Impairment						$ 116,400
Impairment, Intangible Asset, Indefinite-Lived (Excluding Goodwill), Statement of Income or Comprehensive Income [Extensible Enumeration]						Cost of goods sold
IPR & D
Indefinite-lived Intangible Assets [Line Items]
Decrease in indefinite lived assets				$ 132,800
Currently marketed product
Indefinite-lived Intangible Assets [Line Items]
Finite-lived intangible assets, period increase (decrease)				$ 132,800
Cost					132,800	$ 132,800	275,700
Accumulated amortization					38,277	38,277	47,628
Licenses
Indefinite-lived Intangible Assets [Line Items]
Cost	63,600				22,233	22,233	85,800
Accumulated amortization	$ 17,500				$ 7,972	$ 7,972	$ 19,101

Acquisition of Assets (Details) - USD ($) $ in Thousands	1 Months Ended			12 Months Ended
Acquisition of Assets (Details) - USD ($) $ in Thousands	May 31, 2023	Feb. 28, 2023	Dec. 31, 2022	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Asset Acquisition [Line Items]
Research and development				$ 77,707	$ 311,681	$ 44,966
Cerveau Technologies, Inc
Asset Acquisition [Line Items]
Payment for acquisitions	$ 10,000	$ 35,300
Asset acquisition, additional milestone payments		51,000
Cerveau Technologies, Inc \| Sales Milestones
Asset Acquisition [Line Items]
Asset acquisition, additional milestone payments		1,200,000
Cerveau Technologies, Inc \| Research Revenue Milestones
Asset Acquisition [Line Items]
Asset acquisition, additional milestone payments		$ 13,500
POINT Biopharma
Asset Acquisition [Line Items]
Payment for acquisitions			$ 260,000
Asset acquisition, additional milestone payments			1,800,000
Research and development					$ 260,000
PNT2002 License Agreement
Asset Acquisition [Line Items]
Payment for acquisitions			$ 250,000
Royalty percentage			20.00%
PNT2002 License Agreement \| Sales Milestones
Asset Acquisition [Line Items]
Asset acquisition, additional milestone payments			$ 1,300,000
PNT2002 License Agreement \| Regulatory Milestones
Asset Acquisition [Line Items]
Asset acquisition, additional milestone payments			281,000
PNT2003 License Agreement
Asset Acquisition [Line Items]
Payment for acquisitions			$ 10,000
Royalty percentage			15.00%
PNT2003 License Agreement \| Sales Milestones
Asset Acquisition [Line Items]
Asset acquisition, additional milestone payments			$ 275,000
PNT2003 License Agreement \| Regulatory Milestones
Asset Acquisition [Line Items]
Asset acquisition, additional milestone payments			$ 34,500

Revenue from Contracts with Customers - Schedule Of Contract Costs (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Revenue from Contract with Customer [Abstract]
Amounts included in the contract liability at the beginning of the period	$ 682	$ 244

Revenue from Contracts with Customers

12 Months Ended

Dec. 31, 2023

Revenue from Contract with Customer [Abstract]

Revenue from Contract with Customers

Revenue from Contracts with Customers

Revenue Recognition

Revenue is recognized when a customer obtains control of promised goods or services. The amount of revenue recognized reflects the consideration to which the Company expects to be entitled to receive in exchange for these goods or services. To achieve this core principle, the Company applies the following five steps: (1) identify the contracts with a customer; (2) identify the performance obligations in the contract; (3) determine the transaction price; (4) allocate the transaction price to the performance obligations in the contract; and (5) recognize revenue when (or as) the Company satisfies a performance obligation.

Disaggregation of Revenue

The following table summarizes revenue by revenue source as follows:


	Year Ended December 31,
Major Products/Service Lines (in thousands)	2023		2022		2021
Product revenue, net(1)	$	1,263,068	$	887,038	$	400,356
License and royalty revenues(2)	33,361		48,023		24,852
Total revenues	$	1,296,429	$	935,061	$	425,208

______________________________

(2)The Company recognized $24.0 million license revenue in the first quarter of 2022 related to an agreement with Novartis Pharma AG.

The Company classifies its revenues into three product categories: Radiopharmaceutical Oncology, Precision Diagnostics, and Strategic Partnerships and Other Revenue. Radiopharmaceutical Oncology includes PYLARIFY and AZEDRA. In 2023, the Company announced its decision to discontinue the production and promotion of AZEDRA and it does not expect AZEDRA to contribute to the business after the first quarter of 2024. Precision Diagnostics includes DEFINITY, TechneLite and other diagnostic imaging products. Strategic Partnerships and Other Revenue includes strategic partnerships and other arrangements related to other products of the Company, including our royalty revenue from our license of RELISTOR. On August 2, 2023, the Company sold the RELISTOR royalty asset under its license agreement with Bausch; the Company retained the rights to future sales-based milestone payments. During the fourth quarter of 2023, the Company earned a $15.0 million sales-based milestone payment.

On January 31, 2022, the Company entered into a global settlement agreement with Novartis Pharma AG (“Novartis”), Advanced Accelerator Applications USA, Inc., Endocyte, Inc. and their affiliates (the “Novartis Agreement”) to settle certain disputes between the parties. Under the Novartis Agreement, Novartis agreed to make a lump sum payment to the Company, as well as to reimburse the Company for certain fees and expenses in connection with certain German litigation, and the Company agreed to license certain intellectual property to Novartis. In addition, the Company agreed to supply PYLARIFY for clinical purposes at an arms-length value which will be recorded revenue in the future as product is provided. In accordance with the Company's ASC 606, Revenue from Contracts with Customers, assessment, Novartis is considered to be a customer. The Company determined that the $24.0 million constituted a single element which was satisfied on the date of the execution of the Novartis Agreement. The Company determined that the license of intellectual property carried a fair value of $24.0 million. As such, the Company assigned the value to the fair value of the license, which constitutes the entire transaction price and does not require further allocation. The Company determined that the $24.0 million represented the point at which the licensee was able to use and benefit from the license and recognized revenue when the license was granted to Novartis upon execution of the Novartis Agreement. The Company recognized the $24.0 million fee as revenue on its consolidated statement of operations for the quarter ended March 31, 2022. The Company received the $24.0 million payment in April 2022.

Revenue by product category on a net basis is as follows:


	Year Ended December 31,
(in thousands)	2023		2022		2021
PYLARIFY	$	851,303	$	527,405	$	43,414
Other radiopharmaceutical oncology	3,130		4,102		5,473
Total radiopharmaceutical oncology	854,433		531,507		48,887
DEFINITY	279,768		244,993		232,759
TechneLite	87,370		88,864		91,293
Other precision diagnostics	22,980		22,825		26,973
Total precision diagnostics	390,118		356,682		351,025
Strategic Partnerships and other revenue	51,878		46,872		25,296
Total revenues	$	1,296,429	$	935,061	$	425,208

Product Revenue, Net

The Company sells its products principally to hospitals, independent diagnostic testing facilities, and radiopharmacies. The Company considers customer purchase orders, which in some cases are governed by master sales or group purchasing organization agreements, to be the contracts with a customer.

For each contract, the Company considers the promise to transfer products, each of which is distinct, to be the identified performance obligations. In determining the transaction price, the Company evaluates whether the price is subject to refund or adjustment to determine the net consideration to which the Company expects to be entitled.

The Company typically invoices customers upon satisfaction of identified performance obligations. As the Company’s standard payment terms are 30 to 60 days from invoicing, the Company has elected to use the significant financing component practical expedient.

The Company allocates the transaction price to each distinct product based on their relative standalone selling price. The product price as specified on the purchase order is considered the standalone selling price as it is an observable input which depicts the price as if sold to a similar customer in similar circumstances.

Revenue is recognized when control of the product is transferred to the customer (i.e., when the Company’s performance obligation is satisfied), which typically occurs upon delivery to the customer. Further, in determining whether control has transferred, the Company considers if there is a present right to payment and legal title, along with risks and rewards of ownership having transferred to the customer.

Frequently, the Company receives orders for products to be delivered over multiple dates that may extend across several reporting periods. The Company invoices for each delivery upon shipment and recognizes revenues for each distinct product delivered, assuming transfer of control has occurred.

The Company generally does not separately charge customers for shipping and handling costs, but any shipping and handling costs charged to customers are included in product revenue, net. Taxes collected from customers relating to product sales and remitted to governmental authorities are excluded from revenues.

Variable Consideration

Revenues from product sales are recorded at the net sales price (transaction price), which includes estimates of variable consideration for which reserves are established for discounts, returns, rebates and allowances that are offered within contracts between the Company and its customers. These reserves are based on the amounts earned or to be claimed on the related sales and are classified as a current liability. Where appropriate, these estimates take into consideration a range of possible outcomes which are probability-weighted for relevant factors such as the Company’s historical experience, current contractual and statutory requirements, specific known market events and trends, industry data and forecasted customer buying and payment patterns. Overall, these reserves reflect the Company’s best estimates of the amount of consideration to which it is entitled based on the terms of the contract. The amount of variable consideration which is included in the transaction price may be constrained, and is included in the net sales price only to the extent that it is probable that a significant reversal in the amount of the cumulative revenue recognized will not occur in a future period. Actual amounts of consideration ultimately received may differ from the

Company’s estimates. If actual results in the future vary from the Company’s estimates, the Company adjusts these estimates, which would affect product revenue and earnings in the period such variances become known.

Rebates and Allowances: The Company provides certain customers with rebates and allowances that are explicitly stated in the Company’s contracts and are recorded as a reduction of revenue in the period the related product revenue is recognized. The Company establishes a liability for such amounts, which is included in accrued expenses in the accompanying consolidated balance sheets. These rebates and allowances result from performance-based offers that are primarily based on attaining contractually specified sales volumes and administrative fees the Company is required to pay to group purchasing organizations. The Company estimates the amount of rebates and allowances that are explicitly stated in the Company’s contracts based on a combination of actual purchases and an estimate of the customer’s buying patterns.

Product Returns: The Company generally offers customers a limited right of return due to non-conforming product. The Company estimates the amount of its product sales that may be returned by its customers and records this estimate as a reduction of revenue in the period the related product revenue is recognized. The Company currently estimates product return liabilities using its historical product return information and considers other factors that it believes could significantly impact its expected returns, including product recalls. Reserves for product returns are not significant to the Company due to the nature of its products including radiopharmaceutical products with limited half-lives.

An analysis of the amount of, and change in, reserves is summarized as follows:


(in thousands)	Rebates and Allowances
Balance, January 1, 2022	$	10,977
Provision related to current period revenues	26,683
Adjustments relating to prior period revenues	70
Payments or credits made during the period	(24,331)
Balance, December 31, 2022	13,399
Provision related to current period revenues	32,308
Adjustments relating to prior period revenues	(453)
Payments or credits made during the period	(29,184)
Balance, December 31, 2023	$	16,070

License and Royalty Revenues

The Company has entered into licensing agreements, under which it licenses certain rights to third parties. The terms of these arrangements typically include payment to the Company of one or more of the following: non-refundable, up-front license fees; development, regulatory and commercial milestone payments; and royalties on net sales of licensed products. The Company also has distribution licenses which are treated as combined performance obligations with the delivery of its products and are classified as product revenue, net.

In determining the appropriate amount of revenue to be recognized as it fulfills its obligations under each of its agreements, the Company performs the five-step approach stated earlier. The Company uses judgment in determining the number of performance obligations in a license agreement by assessing whether the license is distinct or should be combined with another performance obligation, as well as the nature of the license. As part of the accounting for these arrangements, the Company must develop assumptions that require judgment to determine the stand-alone selling price for each performance obligation identified in the contract. The Company uses key assumptions to determine the stand-alone selling price, which may include market conditions, reimbursement rates for personnel costs, development timelines and probabilities of regulatory success.

Licenses of intellectual property: If the license to the Company’s intellectual property is determined to be distinct from the other performance obligations identified in the arrangement, the Company recognizes revenues from non-refundable, up-front fees allocated to the license when the license is transferred to the customer and the customer is able to use and benefit from the license. For licenses that are bundled with other promises, the Company utilizes judgment to assess the nature of the combined performance obligation to determine whether the combined performance obligation is satisfied over time or at a point in time and, if over time, the appropriate method of measuring progress for purposes of recognizing revenue from non-refundable, up-front fees. The Company evaluates the measure of progress each reporting period and, if necessary, adjusts the measure of performance and related revenue recognition.

Milestone Payments: At the inception of each arrangement that includes development or sales milestone payments, the Company evaluates whether the milestones are considered probable of being reached and estimates the amount to be included in the transaction price using the most likely amount method. If it is probable that a significant revenue reversal would not occur, the associated milestone value is included in the transaction price. Milestone payments that are outside the control of the Company or the licensee, such as regulatory approvals, are not considered probable of being achieved until those approvals are received. The transaction price is then allocated to each performance obligation on a relative stand-alone selling price basis, for which the Company recognizes revenue as or when the performance obligations under the contract are satisfied. At the end of each subsequent reporting period, the Company re-evaluates the probability of achievement of such milestones and any related constraint, and if necessary, adjusts its estimate of the overall transaction price. Any such adjustments are recorded on a cumulative catch-up basis, which would affect license and royalty revenues and earnings in the period of adjustment. At December 31, 2023, the variable consideration for the milestone payments is constrained and is excluded from contract price until the milestone is achieved by the customer.

Royalty Revenues: For arrangements that include sales-based royalties, including milestone payments based on the level of sales, and the license is deemed to be the predominant item to which the royalties relate, the Company recognizes revenue at the later of (i) when the related sales occur, or (ii) when the performance obligation to which some or all of the royalty has been allocated has been satisfied (or partially satisfied).

Contract Costs

The Company recognizes an asset for incremental costs of obtaining a contract with a customer if it expects to recover those costs. The Company’s sales incentive compensation plans qualify for capitalization since these plans are directly related to sales achieved during a period of time. However, the Company has elected the practical expedient to expense the costs as they are incurred, within sales and marketing expenses, since the amortization period is less than one year.

The Company recognized certain revenues as follows:


	Year Ended December 31,
(in thousands)	2023		2022
Amounts included in the contract liability at the beginning of the period	$	682	$	244

The Company did not record any revenue related to performance obligations satisfied (or partially satisfied) in previous periods during the years ended December 31, 2023 and 2022.

The Company’s performance obligations are typically part of contracts that have an original expected duration of one year or less. As such, the Company is not disclosing the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied (or partially satisfied) as of the end of the reporting period.

- Definition

The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 9
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-9

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 10
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-10

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 15
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-15

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (e)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (b)(2)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-13

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Name Accounting Standards Codification
-Topic 606
-Publisher FASB
-URI https://asc.fasb.org//606/tableOfContent

+ Details

Stock-Based Compensation - Schedule of Total Stockholder Return Restricted Awards (Details) - Total Stockholder Return Restricted Stock Awards - USD ($)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected volatility	52.80%	56.60%	54.00%
Risk-free interest rate	4.60%	1.70%	30.00%
Expected life (in years)	2 years 9 months 18 days	2 years 9 months 18 days	2 years 9 months 18 days
Expected dividend yield	$ 0	$ 0	$ 0

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

+ Details

Derivative Instruments (Details) - USD ($)		12 Months Ended
Derivative Instruments (Details) - USD ($)	Dec. 02, 2022	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Mar. 31, 2020
Derivative [Line Items]
Proceeds from interest rate swap termination		$ 0	$ 5,583,000	$ 0
Interest rate swaps
Derivative [Line Items]
Proceeds from interest rate swap termination	$ 5,600,000
Other comprehensive income (loss), cash flow hedge, gain (loss), reclassification, after tax	$ 5,500,000
Cash Flow Hedge \| Interest rate swaps
Derivative [Line Items]
Notional amount					$ 100,000,000
Average fixed interest rate					0.82%

Accrued Expenses and Other Liabilities and Other Long-Term Liabilities

12 Months Ended

Dec. 31, 2023

Payables and Accruals [Abstract]

Accrued Expenses and Other Liabilities and Other Long-Term Liabilities

Accrued expenses and other liabilities and other long-term liabilities are comprised of the following:


	December 31,
(in thousands)	2023		2022
Compensation and benefits	$	36,331	$	30,425
Freight, distribution and operations	67,529		49,067
Accrued rebates, discounts and chargebacks	16,070		13,399
Accrued professional fees	10,244		8,668

Other	15,164		25,525
Total accrued expenses and other liabilities	$	145,338	$	127,084

Operating lease liabilities (Note 16)	$	54,453	$	25,442
Long-term contingent liability (Note 4)	2,700		11,900
Other long-term liabilities	6,168		8,813
Total other long-term liabilities	$	63,321	$	46,155

Leases - Additional Information (Details) $ in Thousands	12 Months Ended
Leases - Additional Information (Details) $ in Thousands	Dec. 31, 2021 USD ($)	Dec. 31, 2023 USD ($) lease	Sep. 01, 2023 USD ($)	May 31, 2023 USD ($)	Dec. 31, 2022 USD ($)	Feb. 28, 2022 USD ($)	Oct. 31, 2021 USD ($)	Sep. 30, 2021	Jun. 19, 2020 USD ($)
Lessee, Lease, Description [Line Items]
Number of leases \| lease		2
Operating lease liability		$ 56,357
Operating lease, right-of-use asset		$ 45,325			$ 19,033
Lessor term of contract								9 years
Impairment, lessor asset under operating lease	$ 9,500
New York City
Lessee, Lease, Description [Line Items]
Operating lease liability									$ 18,600
Somerset, New Jersey
Lessee, Lease, Description [Line Items]
Operating lease liability							$ 700		$ 600
Bedford, Massachusetts
Lessee, Lease, Description [Line Items]
Term of contract		15 years 3 months 29 days
Operating lease liability			$ 23,500	$ 6,000	$ 11,000	$ 11,000
Operating lease, right-of-use asset			$ 23,500	$ 6,000
Renewal term			5 years

Derivative Instruments	12 Months Ended
Derivative Instruments	Dec. 31, 2023
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Derivative Instruments	Derivative Instruments The Company has used interest rate swaps to reduce the variability in cash flows associated with a portion of the Company’s forecasted interest payments on its variable rate debt. In March 2020, the Company entered into interest rate swap contracts to fix the LIBOR rate on a notional amount of $100.0 million through May 31, 2024. The average fixed LIBOR rate on the interest rate swaps was approximately 0.82%. This agreement involved the receipt of floating rate amounts in exchange for fixed rate interest payments over the life of the agreement without an exchange of the underlying principal amount. The interest rate swaps were designated as cash flow hedges. In accordance with hedge accounting, the interest rate swaps are recorded on the Company’s consolidated balance sheets at fair value, and changes in the fair value of the swap agreements were recorded to other comprehensive loss and reclassified to interest expense in the period during which the hedged transaction affected earnings or it will become probable that the forecasted transaction would not occur. On December 2, 2022, the Company voluntarily terminated the interest rate swap contracts in connection with the refinancing of debt. Upon termination, the Company received approximately $5.6 million in cash and the remaining balance of approximately $5.5 million in accumulated other comprehensive income (loss) related to the interest rate swap contracts were reclassified into earnings.

Stock-Based Compensation - Schedule of Stock-Based Compensation Expense Recognized (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total stock-based compensation expense	$ 50,507	$ 29,262	$ 15,934
Cost of goods sold
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total stock-based compensation expense	9,126	4,422	2,370
Sales and marketing
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total stock-based compensation expense	9,500	6,185	2,472
General and administrative
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total stock-based compensation expense	24,807	14,876	9,092
Research and development
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total stock-based compensation expense	$ 7,074	$ 3,779	$ 2,000

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

+ Details

Income Taxes - Schedule of (Benefit) Provision for Income Taxes (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Current
Federal	$ 110,108	$ 42,532	$ 0
State	29,806	4,302	(8,166)
International	0	(166)	(30)
Current income tax expense (benefit), total	139,914	46,668	(8,196)
Deferred
Federal	(45,252)	(39,920)	1,048
State	(10,739)	(8,315)	3,058
International	359	219	331
Deferred income tax expense (benefit), total	(55,632)	(48,016)	4,437
Income tax expense (benefit)	$ 84,282	$ (1,348)	$ (3,759)

Property, Plant & Equipment, Net - Schedule of Property, Plant & Equipment (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Property, Plant & Equipment [Line Items]
Property, plant and equipment, gross	$ 253,720	$ 222,294
Less: accumulated depreciation and amortization	(107,023)	(100,128)
Property, plant and equipment, net	146,697	122,166
Land
Property, Plant & Equipment [Line Items]
Property, plant and equipment, gross	9,480	13,450
Buildings
Property, Plant & Equipment [Line Items]
Property, plant and equipment, gross	73,441	76,329
Machinery, equipment and fixtures
Property, Plant & Equipment [Line Items]
Property, plant and equipment, gross	102,576	92,604
Computer software
Property, Plant & Equipment [Line Items]
Property, plant and equipment, gross	27,259	25,864
Construction in progress
Property, Plant & Equipment [Line Items]
Property, plant and equipment, gross	$ 40,964	$ 14,047

Asset Retirement Obligations (Tables)

12 Months Ended

Dec. 31, 2023

Asset Retirement Obligation Disclosure [Abstract]

Schedule of Asset Retirement Obligations

The following table provides a summary of the changes in the Company’s asset retirement obligations:


(in thousands)	Amount
Balance, January 1, 2022	$	20,833
Change in useful life estimate	280
Accretion expense	1,430
Balance, December 31, 2022	22,543

Accretion expense	373
Balance, December 31, 2023	$	22,916

Description of Business	12 Months Ended
Description of Business	Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Description of Business	Description of Business Lantheus Holdings, Inc., a Delaware corporation, is the parent company of Lantheus Medical Imaging, Inc. (“LMI”) and LMI is the parent company of Progenics Pharmaceuticals, Inc., a Delaware corporation (“Progenics”), and Cerveau Technologies, Inc. (“Cerveau”). See “Progenics Acquisition” and “Acquisition of Assets”, respectively. The Company develops, manufactures and commercializes innovative diagnostic and therapeutic products that assist clinicians in the diagnosis and treatment of cancer, heart disease and other diseases. The Company believes its diagnostic products result in improved diagnostic information that enables healthcare providers to better detect and characterize, or rule out, disease, potentially achieving improved patient outcomes, reducing patient risk and limiting overall costs throughout the healthcare system. The Company’s commercial products are used by cardiologists, internal medicine physicians, nuclear medicine physicians, oncologists, radiologists, sonographers, technologists, and urologists working in a variety of clinical settings. The Company produces and markets its products throughout the U.S., selling primarily to hospitals, independent diagnostic testing facilities, and radiopharmacies. The Company sells its products outside the U.S. through a combination of direct distribution in Canada and third-party distribution relationships in Europe, Canada, Australia, Asia-Pacific, Central America and South America. Sales of the Company’s prostate cancer diagnostic imaging agent, PYLARIFY (as defined below), are generated in the U.S. through an internal PYLARIFY sales team, as well as a sales team at some of the Company’s positron emission tomography (“PET”) manufacturing facilities (“PMF”) partners. Sales of the Company’s ultrasound enhancing agent, DEFINITY, are generated in the U.S. through an internal DEFINITY sales team. In the U.S., the Company’s other nuclear imaging products, including TechneLite, Xenon, NEUROLITE and CARDIOLITE, are primarily sold to commercial radiopharmacies, the majority of which are controlled by or associated with PharmaLogic, Cardinal, RLS, UPPI, and Jubilant Radiopharma. Research revenue is derived from existing partnerships with pharmaceutical companies that use our products and product candidates in clinical trials and includes milestone and dose-related payments. A small portion of the Company’s nuclear imaging product sales in the U.S. are generated through the Company’s internal sales force to hospitals and clinics that maintain their own in-house radiopharmaceutical preparation capabilities. In Europe, Australia, Asia-Pacific, Central America and South America, the Company generally relies on third-party distributors to market, sell and distribute its nuclear imaging and ultrasound enhancing agent products, either on a country-by-country basis or on a multi-country regional basis. The Company’s executive offices are located in Bedford, MA, with additional offices in North Billerica, MA, Somerset, NJ, Montreal, Canada and Lund, Sweden. Progenics Acquisition On June 19, 2020 (the “Closing Date”), pursuant to the Amended and Restated Agreement and Plan of Merger, dated as of February 20, 2020 (the “Merger Agreement”), by and among Holdings, Plato Merger Sub, Inc., a wholly-owned subsidiary of Holdings (“Merger Sub”), and Progenics, Holdings completed the acquisition of Progenics by means of a merger of Merger Sub with and into Progenics, with Progenics surviving such merger as a wholly-owned subsidiary of Holdings (the “Progenics Acquisition”). In connection with the Progenics Acquisition, Lantheus Holdings issued 26,844,877 shares of Lantheus Holdings common stock and 86,630,633 contingent value rights (each a “CVR”) tied to the financial performance of PYLARIFY to former Progenics stockholders and option holders. Each CVR entitled its holder to receive a pro rata share of aggregate cash payments equal to 40% of United States (“U.S.”) net sales generated by PYLARIFY in 2022 and 2023 in excess of $100.0 million and $150.0 million, respectively. The Company’s aggregate payments in respect of the CVRs, together with any other non-stock consideration treated as paid in connection with the Progenics Acquisition, was capped at 19.9% of the total consideration the Company paid in the Progenics Acquisition. Based on the Company’s 2022 PYLARIFY net sales, the Company determined that the aggregate payment obligation under the CVRs was $99.6 million, which was the maximum amount payable. The Company paid out this amount in May 2023 in full satisfaction of the CVRs.

Commitments and Contingencies (Tables)

12 Months Ended

Dec. 31, 2023

Commitments and Contingencies Disclosure [Abstract]

Schedule of Future Payments Required

As of December 31, 2023, future payments required under purchase commitments are as follows:


(in thousands)	Amount
2024	2,716
2025	2,716
2026	2,716
2027	2,716
2028 and thereafter	—
Total	$	10,864

Pay vs Performance Disclosure - USD ($) $ in Thousands	12 Months Ended
Pay vs Performance Disclosure - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Pay vs Performance Disclosure
Net income (loss)	$ 326,661	$ 28,067	$ (71,279)

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

+ Details

Summary of Significant Accounting Policies - Schedule Of Other Loss (Income) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Accounting Policies [Abstract]
Foreign currency losses	$ 21	$ 256	$ 274
Tax indemnification expense, net	4,943	9,554	7,121
Interest income	(19,638)	(2,613)	(45)
Interest rate swap termination	0	(5,494)	0
Gain on sale of RELISTOR licensed intangible asset associated with net sales royalties	(51,789)	0	(15,263)
Other	143	0	0
Total other (income) loss	$ (66,320)	$ 1,703	$ 7,350

Long-Term Debt, Net, and Other Borrowings - Schedule of Minimum Payments Maturities of Principal Obligations Under Term Facility (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Debt Disclosure [Abstract]
2024	$ 0
2025	0
2026	0
2027	575,000
2028	0
Total principal outstanding	575,000
Unamortized debt issuance costs	(13,955)
Finance lease liabilities	1,448
Total	562,493
Less: current portion	(823)
Total long-term debt, net, and other borrowings	$ 561,670	$ 557,712

Intangibles, Net and Goodwill

12 Months Ended

Dec. 31, 2023

Goodwill and Intangible Assets Disclosure [Abstract]

Intangibles, Net and Goodwill

Intangibles, net, consisted of the following:


	December 31, 2023
(in thousands)	Useful Lives (in years)	Amortization Method	Cost		Accumulated Amortization		Net
Trademarks	15 – 25	Straight-Line	$	13,540	$	(12,216)	$	1,324
Customer relationships	15 – 25	Accelerated	157,995		(117,574)		40,421
Currently marketed product	9 – 15	Straight-Line	132,800		(38,277)		94,523
Licenses	11 – 16	Straight-Line	22,233		(7,972)		14,261
Developed technology	9	Straight-Line	2,400		(944)		1,456

Total			$	328,968	$	(176,983)	$	151,985


	December 31, 2022
(in thousands)	Useful Lives (in years)	Amortization Method	Cost		Accumulated Amortization		Net
Trademarks	15 – 25	Straight-Line	$	13,540	$	(12,061)	$	1,479
Customer relationships	15 – 25	Accelerated	96,681		(95,009)		1,672
Currently marketed product	9 – 15	Straight-Line	275,700		(47,628)		228,072
Licenses	11 – 16	Straight-Line	85,800		(19,101)		66,699
Developed technology	9	Straight-Line	2,400		(677)		1,723
IPR&D	N/A	N/A	15,640		—		15,640
Total			$	489,761	$	(174,476)	$	315,285

The Company recorded amortization expense for its intangible assets of $46.4 million, $33.2 million and $27.5 million for the years ended December 31, 2023, 2022 and 2021, respectively.

In May 2021, PyL (18F-DCFPyL) was approved by the FDA under the name PYLARIFY. Accordingly, the Company reclassified the associated asset of $132.8 million from IPR&D to currently marketed products and commenced amortization of the asset.

On August 2, 2023, the Company sold the right to its RELISTOR royalty asset under its license agreement with Bausch; the Company retained the rights to future sales-based milestone payments. The Company received an initial payment of approximately $98.0 million in connection with the sale and has the right to receive an additional payment from the buyer of $5.0 million if worldwide net sales of RELISTOR in 2025 exceed a specified threshold. The additional payment would be recognized upon achievement of the specified threshold. Decreases of $63.6 million of license assets and $17.5 million of associated accumulated amortization, as well as a gain of $51.8 million were recorded as a result of the sale. During the fourth quarter of 2023, the Company earned a $15.0 million sales-based milestone payment.

In March 2023, the Company stopped all development activities in relation to a future indication associated with AZEDRA, which was classified as an IPR&D intangible asset. The asset group, which consisted of the IPR&D asset and a currently marketed product (the “AZEDRA intangible asset group”), was assessed for impairment. The Company considered several factors in estimating the future projections of revenues and cash flows of the AZEDRA intangible asset group as part of the impairment testing. The Company concluded that the carrying amount exceeded the fair value of the AZEDRA intangible asset group, which had no value. The Company recorded a non-cash impairment charge of $15.6 million in research and development expenses relating to the IPR&D asset and $116.4 million in cost of goods sold relating to the currently marketed indication of AZEDRA in the consolidated statement of operations for the year ended December 31, 2023.

On August 15, 2023, the Company announced that it had made the decision to discontinue the production and promotion of AZEDRA and would be winding down its Somerset, New Jersey manufacturing site. The Company will continue manufacturing AZEDRA into the first quarter of 2024, to the extent feasible, with the goal of providing doses of AZEDRA to current patients so they can complete their treatment regimen. See Note 7, “Property, Plant and Equipment, Net” for impairment analysis.

In February 2023, the Company entered into an agreement with the stockholders of Cerveau to purchase all of the outstanding capital stock of Cerveau for approximately $35.3 million. In May 2023, upon successful completion of a technology transfer, the Company paid $10.0 million to the selling stockholders of Cerveau. This additional contingent payment was capitalized as part of the

asset cost and increased the Company’s customer relationship intangible assets. See Note 21, “Acquisition of Assets” for further discussion of the Cerveau acquisition.

The below table summarizes the estimated aggregate amortization expense expected to be recognized on the above intangible assets:


(in thousands)	Amount
2024	$	39,726
2025	24,409
2026	25,206
2027	19,680
2028	16,195
2029 and thereafter	26,769
Total	$	151,985

Subsequent Event (Details) - Subsequent Event $ in Millions	Jan. 09, 2024 USD ($)
Licenses \| Perspective Therapeutics, Inc
Subsequent Event [Line Items]
Payments to acquire license agreement	$ 28
Perspective Therapeutics, Inc
Subsequent Event [Line Items]
Ownership percentage	19.90%
Payments to acquire interest	$ 33

Subsequent Event	12 Months Ended
Subsequent Event	Dec. 31, 2023
Subsequent Events [Abstract]
Subsequent Event	Subsequent Event On January 9, 2024, the Company entered into multiple strategic agreements with Perspective Therapeutics, Inc. (“Perspective”), a radiopharmaceutical company that is pioneering advanced treatment applications for cancers throughout the body. Under the agreements: •The Company obtained an option to exclusively license Perspective’s Pb212-VMT-⍺-NET, a clinical stage alpha therapy in development for the treatment of neuroendocrine tumors, and an option to co-develop certain early stage therapeutic candidates targeting prostate cancer using Perspective’s innovative platform technology, for an aggregate upfront payment of $28 million in cash; •Lantheus agreed to purchase up to 19.9% of Perspective’s outstanding shares of common stock for up to approximately $33 million, subject to completion of a qualified third party financing transaction and certain other closing conditions; and •Perspective agreed to acquire the assets and associated lease of Lantheus’ radiopharmaceutical manufacturing facility in Somerset, New Jersey for an undisclosed price, subject to customary closing conditions including regulatory approval.