We commercially launched Gvoke PFS and Gvoke HypoPen for the treatment of severe hypoglycemia in people with diabetes in November 2019 and July 2020, respectively. Total net sales of Gvoke were $8.8 million and $2.0 million for the three months ended June 30, 2021 and 2020, respectively. Total net sales of Gvoke were $16.9 million and $3.7 million for the six months ended June 30, 2021 and 2020, respectively. Net sales represent gross product sales less estimated allowances for patient copay assistance programs, prompt payment discounts, payor rebates, chargebacks, service fees, and product returns, all of which are recorded at the time of sale to the pharmaceutical wholesaler or other customer. We apply significant judgments and estimates in determining some of these allowances. If actual results differ from our estimates, we make adjustments to these allowances in the period in which the actual results or updates to estimates become known. During the three months ended March 31, 2021, we made adjustments to rebate and patient assistance copay accruals which were recorded in prior years based on actual claims experience to date, which increased revenue by $0.9 million. During the three months ended June 30, 2021, we made adjustments to the accrued returns reserve related to prior years' sales based on actual returns experience, which decreased revenue by $0.9 million. For the six months ended June 30, 2021, these adjustments offset and together had no impact on net sales.
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