OptiNose (OPTN) 10-Q 12 Aug 19 2019 Q2 Quarterly report Financial data

Document and Entity Information

Document and Entity Information Document - shares	6 Months Ended
	Jun. 30, 2019	Aug. 09, 2019
Document and Entity Information [Abstract]
Entity Registrant Name	OptiNose, Inc.
Entity Central Index Key	0001494650
Current Fiscal Year End Date	--12-31
Entity Filer Category	Accelerated Filer
Document Type	10-Q
Document Period End Date	Jun. 30, 2019
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	Q2
Amendment Flag	false
Entity Common Stock, Shares Outstanding		41,435,918
Entity Emerging Growth Company	true
Entity Small Business	true
Entity Ex Transition Period	true
Entity Current Reporting Status	Yes
Entity Shell Company	false
Entity Interactive Data Current	Yes

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Current assets:
Cash and cash equivalents	$ 143,963	$ 200,990
Accounts receivable, net	9,311	2,310
Grants and other receivables	290	242
Inventory	4,260	7,132
Prepaid expenses and other current assets	3,030	2,183
Total current assets	160,854	212,857
Property and equipment, net	3,531	3,884
Other assets	2,187	248
Total assets	166,572	216,989
Current liabilities:
Accounts payable	2,811	7,116
Accrued expenses and other current liabilities	21,556	18,421
Deferred other income	0	160
Total current liabilities	24,367	25,697
Long-term debt, net	72,869	72,500
Other liabilities	864	181
Total liabilities	98,100	98,378
Stockholders' equity:
Common stock, $0.001 par value; 200,000,000 shares authorized at June 30, 2019 and December 31, 2018; 41,430,918 and 41,227,530 shares issued and outstanding at June 30, 2019 and December 31, 2018, respectively	41	41
Additional paid-in capital	442,676	436,554
Accumulated deficit	(374,178)	(317,927)
Accumulated other comprehensive loss	(67)	(57)
Total stockholders' equity	68,472	118,611
Total liabilities and stockholders' equity	$ 166,572	$ 216,989

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - $ / shares	Jun. 30, 2019	Dec. 31, 2018
Statement of Financial Position [Abstract]
Common stock, par value (usd per share)	$ 0.001	$ 0.001
Shares authorized (in shares)	200,000,000	200,000,000
Shares issued (in shares)	41,430,918	41,227,530
Shares outstanding (in shares)	41,430,918	41,227,530

Consolidated Statements of Oper

Consolidated Statements of Operations - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Total revenues	$ 6,677	$ 1,274	$ 11,153	$ 2,139
Costs and expenses:
Licensing revenues	1,089	351	1,827	551
Research and development	5,295	2,046	9,857	3,747
Selling, general and administrative	26,000	21,860	52,340	49,871
Total operating expenses	32,384	24,257	64,024	54,169
Loss from operations	(25,707)	(22,983)	(52,871)	(52,030)
Other (income) expense:
Grant and other income	0	(145)	0	(333)
Interest income	(716)	(582)	(1,400)	(1,058)
Interest expense	2,389	2,301	4,777	4,494
Foreign currency (gains) losses	(3)	24	3	21
Net loss	$ (27,377)	$ (24,581)	$ (56,251)	$ (55,154)
Net loss per share of common stock, basic and diluted (in USD per share)	$ (0.66)	$ (0.64)	$ (1.36)	$ (1.44)
Weighted average common shares outstanding, basic and diluted (in shares)	41,310,608	38,688,366	41,283,478	38,271,101
Net product revenues
Total revenues	$ 6,677	$ 1,274	$ 10,653	$ 2,139
Licensing revenues
Total revenues	$ 0	$ 0	$ 500	$ 0

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Loss - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Statement of Comprehensive Income [Abstract]
Net loss	$ (27,377)	$ (24,581)	$ (56,251)	$ (55,154)
Other comprehensive (loss) income:
Foreign currency translation adjustment	(13)	15	(10)	21
Comprehensive loss	$ (27,390)	$ (24,566)	$ (56,261)	$ (55,133)

Consolidated Statements of Chan

Consolidated Statements of Changes in Stockholders' Equity - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-in Capital	Accumulated Deficit	Accumulated Other Comprehensive Loss
Beginning balance (in shares) at Dec. 31, 2017		37,802,556
Beginning balance at Dec. 31, 2017	$ 154,496	$ 38	$ 365,838	$ (211,269)	$ (111)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Stock compensation expense	2,050		2,050
Exercise of common stock options (in shares)		106,502
Exercise of common stock options	130		130
Foreign currency translation adjustment	7				7
Net loss	(30,572)			(30,572)
Ending balance (in shares) at Mar. 31, 2018		37,909,058
Ending balance at Mar. 31, 2018	126,111	$ 38	368,018	(241,841)	(104)
Beginning balance (in shares) at Dec. 31, 2017		37,802,556
Beginning balance at Dec. 31, 2017	154,496	$ 38	365,838	(211,269)	(111)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net loss	(55,154)
Ending balance (in shares) at Jun. 30, 2018		41,121,557
Ending balance at Jun. 30, 2018	164,333	$ 41	430,803	(266,422)	(89)
Beginning balance (in shares) at Mar. 31, 2018		37,909,058
Beginning balance at Mar. 31, 2018	126,111	$ 38	368,018	(241,841)	(104)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Stock compensation expense	2,135		2,135
Sale of common stock, net of issuance costs (in shares)		2,875,000
Sale of common stock, net of issuance costs	59,926	$ 3	59,923
Exercise of common stock options (in shares)		330,401
Exercise of common stock options	727		727
Exercise of warrants (in shares)		7,098
Exercise of warrants	0
Foreign currency translation adjustment	15				15
Net loss	(24,581)			(24,581)
Ending balance (in shares) at Jun. 30, 2018		41,121,557
Ending balance at Jun. 30, 2018	164,333	$ 41	430,803	(266,422)	(89)
Beginning balance (in shares) at Dec. 31, 2018		41,227,530
Beginning balance at Dec. 31, 2018	118,611	$ 41	436,554	(317,927)	(57)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Stock compensation expense	2,425		2,425
Exercise of common stock options (in shares)		5,000
Exercise of common stock options	15		15
Issuance of common stock under employee stock purchase plan (in shares)		31,892
Issuance of common stock under employee stock purchase plan	173		173
Foreign currency translation adjustment	3				3
Net loss	(28,874)			(28,874)
Ending balance (in shares) at Mar. 31, 2019		41,264,422
Ending balance at Mar. 31, 2019	92,353	$ 41	439,167	(346,801)	(54)
Beginning balance (in shares) at Dec. 31, 2018		41,227,530
Beginning balance at Dec. 31, 2018	118,611	$ 41	436,554	(317,927)	(57)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net loss	(56,251)
Ending balance (in shares) at Jun. 30, 2019		41,430,918
Ending balance at Jun. 30, 2019	68,472	$ 41	442,676	(374,178)	(67)
Beginning balance (in shares) at Mar. 31, 2019		41,264,422
Beginning balance at Mar. 31, 2019	92,353	$ 41	439,167	(346,801)	(54)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Stock compensation expense	2,716		2,716
Exercise of common stock options (in shares)		88,587
Exercise of common stock options	354		354
Issuance of common stock under employee stock purchase plan (in shares)		77,909
Issuance of common stock under employee stock purchase plan	439		439
Foreign currency translation adjustment	(13)				(13)
Net loss	(27,377)			(27,377)
Ending balance (in shares) at Jun. 30, 2019		41,430,918
Ending balance at Jun. 30, 2019	$ 68,472	$ 41	$ 442,676	$ (374,178)	$ (67)

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018
Operating activities:
Net loss	$ (56,251)	$ (55,154)
Adjustments to reconcile net loss to cash used in operating activities:
Depreciation and amortization	592	173
Stock-based compensation	5,117	4,123
Amortization of debt discount and issuance costs	234	180
Changes in operating assets and liabilities:
Accounts receivable	(7,001)	(3,671)
Grants and other receivables	(48)	(165)
Prepaid expenses and other assets	1,096	(859)
Inventory	2,803	(2,723)
Accounts payable	(4,253)	2,917
Accrued expenses and other liabilities	129	7,686
Cash used in operating activities	(57,582)	(47,493)
Investing activities:
Purchases of property and equipment	(423)	(881)
Cash used in investing activities	(423)	(881)
Financing activities:
Proceeds from the sale of common stock	0	63,969
Cash paid for financing costs	0	(6,349)
Proceeds from issuance of common stock under employee stock purchase plan	612	0
Proceeds from the exercise of stock options	369	857
Cash provided by financing activities	981	58,477
Effects of exchange rate changes on cash and cash equivalents	(9)	25
Net (decrease) increase in cash, cash equivalents and restricted cash	(57,033)	10,128
Cash, cash equivalents and restricted cash at beginning of period	201,011	234,875
Cash, cash equivalents and restricted cash at end of period	143,978	245,003
Supplemental disclosure of noncash activities:
Fixed asset purchases within accounts payable and accrued expenses	35	233
Fixed asset additions acquired though tenant allowance	0	267
Financing costs within accounts payable and accrued expenses	0	188
Recognition of initial right-of-use assets	3,724	0
Recognition of initial lease liabilities	$ 4,201	$ 0

Organization and Description of

Organization and Description of Business	6 Months Ended
	Jun. 30, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and Description of Business	Organization and Description of Business OptiNose, Inc. (the Company) was incorporated in Delaware in May 2010 (inception) and has facilities in Yardley, Pennsylvania, Ewing, New Jersey, Oslo, Norway and Swindon, England. The Company's predecessor entity, OptiNose AS, was formed under the laws of Norway in September 2000. In 2010, OptiNose AS became a wholly-owned subsidiary of the Company as part of an internal reorganization. The Company is a specialty pharmaceutical company focused on the development and commercialization of products for patients treated by ear, nose and throat (ENT) and allergy specialists. The Company's first commercial product, XHANCE ® (fluticasone propionate) nasal spray, 93 mcg, is a therapeutic utilizing its proprietary Exhalation Delivery System (EDS) that delivers a topically-acting corticosteroid for the treatment of chronic rhinosinusitis with nasal polyps and, if approved, chronic rhinosinusitis without nasal polyps (also known as chronic sinusitis). XHANCE was approved by the United States (US) Food and Drug Administration (FDA) in September 2017 for the treatment of nasal polyps in patients 18 years of age or older. XHANCE was made widely available through commercial channels in April 2018.

Liquidity

Liquidity	6 Months Ended
	Jun. 30, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Liquidity	Liquidity Since inception, the Company's operations have focused on organization and staffing, business planning, raising capital, establishing an intellectual property portfolio, conducting preclinical studies and clinical trials, pursuing regulatory approvals and most recently, preparing for and launching XHANCE. As of June 30, 2019 , the Company had cash and cash equivalents of $143,963 . On June 11, 2018, the Company and certain stockholders closed an underwritten public offering (the Offering) of 5,750,000 shares of Company common stock (Common Stock) at a price of $22.25 per share. The Offering consisted of 2,875,000 shares of Common Stock sold by the Company and 2,875,000 shares of Common Stock sold by certain stockholders. As a result of the Offering, the Company received $59,917 in net proceeds, after deducting discounts and commissions of $3,678 and offering expenses of approximately $373 payable by the Company. The Company will likely require additional capital in the future secured through equity or debt financings, partnerships, collaborations, or other sources in order to meet the debt service obligations under the Company's outstanding senior secured notes (Senior Secured Notes), including repayment, and to carry out the Company's planned development and commercial activities. If additional capital is not secured when required, the Company may need to delay or curtail its operations until such funding is received. The Company is subject to a number of risks similar to other life sciences companies, including, but not limited to, successful discovery, development and commercialization of its products and product candidates, raising additional capital, the development by its competitors of new technological innovations, protection of proprietary technology and market acceptance of the Company's products.

Basis of Presentation and Summa

Basis of Presentation and Summary of Significant Accounting Policies	6 Months Ended
	Jun. 30, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Basis of Presentation and Summary of Significant Accounting Policies	Basis of Presentation and Summary of Significant Accounting Policies The accompanying unaudited interim consolidated financial statements have been prepared in conformity with US generally accepted accounting principles (GAAP). Any reference in these notes to applicable guidance is meant to refer to GAAP as found in the Accounting Standards Codification (ASC) and Accounting Standards Updates (ASU) of the Financial Accounting Standards Board (FASB). In the opinion of management, the accompanying unaudited interim financial statements include all normal and recurring adjustments (which consist primarily of accruals and estimates that impact the financial statements) considered necessary to present fairly the Company's financial position as of June 30, 2019 and its results of operations for the three and six months ended June 30, 2019 and 2018 and cash flows for the six months ended June 30, 2019 and 2018 . Operating results for the three and six months ended June 30, 2019 are not necessarily indicative of the results that may be expected for the year ending December 31, 2019 . The unaudited interim financial statements, presented herein, do not contain the required disclosures under GAAP for annual financial statements. The accompanying unaudited interim financial statements should be read in conjunction with the annual audited financial statements and related notes as of and for the year ended December 31, 2018 contained in the Company’s annual report on Form 10-K for the year ended December 31, 2018 , filed with the SEC on March 6, 2019. Use of estimates The preparation of the unaudited interim consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the unaudited interim consolidated financial statements and reported amounts of expenses during the reporting period. Due to the uncertainty of factors surrounding the estimates or judgments used in the preparation of the unaudited interim consolidated financial statements, actual results may materially vary from these estimates. Estimates and assumptions are periodically reviewed and the effects of revisions are reflected in the unaudited interim consolidated financial statements in the period they are determined to be necessary. Concentration of credit risk Financial instruments that potentially subject the Company to concentrations of credit risk are primarily cash and accounts receivable. The Company generally invests its cash in deposits with high credit quality financial institutions. Additionally, the Company performs periodic evaluations of the relative credit standing of these financial institutions. The Company has exposure to credit risk in accounts receivable from sales of XHANCE. XHANCE is sold to wholesale pharmaceutical distributors and preferred pharmacy network partners (collectively, Customers), who, in turn, sell XHANCE to pharmacies, hospitals and other customers. Five Customers represent approximately 68% of the Company's accounts receivable at June 30, 2019 and five Customers represent approximately 67% and 68% of the Company's net product sales for the three and six months ended June 30, 2019 , respectively. Fair value of financial instruments At June 30, 2019 and December 31, 2018 , the Company's financial instruments included cash and cash equivalents, accounts receivable, grants receivable, inventory, accounts payable and accrued expenses. The carrying amounts reported in the Company's financial statements for these instruments approximate their respective fair values because of the short-term nature of these instruments. The Company also believes the carrying value of long-term debt approximates fair value at June 30, 2019 as the interest rates are reflective of the rate the Company could obtain on debt with similar terms and conditions. At June 30, 2019 and December 31, 2018 , there were no financial assets or liabilities measured at fair value on a recurring basis. Restricted cash As of June 30, 2019 and December 31, 2018 , the restricted cash balance included in prepaid expenses and other assets was $15 and $20 , respectively. Net Product Revenues The Company accounts for revenue in accordance with ASC Topic 606, Revenue from Contracts with Customers , which was adopted on January 1, 2018. The Company recognizes revenue from XHANCE sales at the point the Customer obtains control of the product, which generally occurs upon delivery. The transaction price that is recognized as revenue for products includes an estimate of variable consideration. The Company’s estimates of variable consideration and determination of whether to include estimated amounts in the transaction price are based largely on an assessment of its anticipated performance and all information (historical, current and forecasted) that is reasonably available. The components of the Company’s variable consideration include the following: Provider Chargebacks and Discounts. Chargebacks for fees and discounts to providers represent the estimated obligations resulting from contractual commitments to sell products to qualified healthcare providers at prices lower than the list prices charged to Customers who directly purchase the product from the Company. Customers charge the Company for the difference between what they pay for the product and the ultimate selling price to the qualified healthcare providers. These components of variable consideration are established in the same period that the related revenue is recognized, resulting in a reduction of product revenue and accounts receivable. Trade Discounts and Allowances. The Company generally provides Customers with discounts that include incentive fees which are explicitly stated in the Company’s contracts. These discounts are recorded as a reduction of revenue and accounts receivable in the period in which the related product revenue is recognized. In addition, the Company reimburses (through discounts and allowances) its Customers for sales order management, data and distribution services. Product Returns. Consistent with industry practice, the Company has a product returns policy that provides Customers a right of return for product purchased within a specified period prior to and subsequent to the product’s expiration date. The Company estimates the amount of its product that may be returned and presents this amount as a reduction of revenue in the period the related product revenue is recognized, in addition to establishing a liability. The Company considers several factors in the estimation process, including expiration dates of product shipped to preferred pharmacy network partners and wholesalers, inventory levels within the distribution channel, product shelf life, prescription trends and other relevant factors. Government Rebates. The Company is subject to discount obligations under state Medicaid programs and Medicare. These reserves are recorded in the same period the related revenue is recognized, resulting in a reduction of product revenue and the establishment of a current liability. The Company’s liability for these rebates consists of estimates of claims for the current quarter and estimated future claims that will be made for product that has been recognized as revenue but remains in the distribution channel inventories at the end of the reporting period. Payor Rebates. The Company contracts with certain third-party payors, primarily health insurance companies and pharmacy benefit managers, for the payment of rebates with respect to utilization of its products. These rebates are based on contractual percentages applied to the amount of product prescribed to patients who are covered by the plan or the organization with which it contracts. The Company estimates these rebates and records such estimates in the same period the related revenue is recognized, resulting in a reduction of product revenue and the establishment of a current liability. Other Incentives. Other incentives that the Company offers include voluntary patient assistance programs, such as co-pay assistance programs, which are intended to provide financial assistance to qualified commercially insured patients with prescription drug co-payments required by payors and coupon programs for cash payors. The calculation of the accruals for this assistance is based on an estimate of claims and the cost per claim that the Company expects to receive associated with product that has been recognized as revenue but remains in the distribution channel inventories at the end of each reporting period. Licensing revenues During the six months ended June 30, 2019 , the Company's licensing revenues were generated pursuant to the terms of a single license agreement (the Inexia License Agreement) with Inexia Limited (Inexia) (Note 8). The Inexia License Agreement includes licensed rights to patented technology, a non-refundable up-front payment, development and sales milestones as well as royalty payments. The Company analyzed the performance obligations under the Inexia License Agreement, the consideration received to date and the consideration the Company could receive in the future as part of its analysis related to ASC 606. The Company recognized the upfront payment received of $500 as licensing revenue during the six months ended June 30, 2019 upon the delivery of the license performance obligation. Net income (loss) per common share Basic net income (loss) per common share is determined by dividing net income (loss) applicable to Common Stock holders by the weighted average common shares outstanding during the period. For the three and six months ended June 30, 2019 and 2018 , the outstanding Common Stock options, Common Stock warrants and shares to be issued under the Company's 2017 Employee Stock Purchase Plan have been excluded from the calculation of diluted net loss per share because their effect would be anti-dilutive. Therefore, the weighted average shares used to calculate both basic and diluted net loss per share are the same. Diluted net loss per common share for the periods presented do not reflect the following potential common shares, as the effect would be antidilutive: June 30, 2019 2018 Stock options 7,983,370 6,126,560 Common stock warrants 1,866,831 1,878,660 Employee stock purchase plan — 53,137 Total 9,850,201 8,058,357 Income taxes In accordance with ASC 270, Interim Reporting , and ASC 740, Income Taxes , the Company is required at the end of each interim period to determine the best estimate of its annual effective tax rate and then apply that rate in providing for income taxes on a current year-to-date (interim period) basis. For the three and six months ended June 30, 2019 and 2018 , the Company recorded no tax expense or benefit due to the expected current year loss and its historical losses. As of June 30, 2019 and December 31, 2018 , the Company has concluded that a full valuation allowance is necessary for all of its net deferred tax assets. The Company had no amounts recorded for uncertain tax positions, interest or penalties in the accompanying consolidated financial statements. Recent accounting pronouncements In August 2018, the FASB issued ASU No. 2018-15, Customer's Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract . ASU 2018-15 requires that certain implementation costs incurred in a cloud computing arrangement be deferred and recognized over the term of the arrangement. The new standard is effective for fiscal years, and interim periods within those fiscal years, beginning after December 15, 2019, and early adoption is permitted. The Company is currently evaluating the potential impact of the adoption of this standard on its results of operations, financial position and cash flows and related disclosures. In August 2018, the FASB issued ASU No. 2018-13, Disclosure Framework - Changes to the Disclosure Requirements for Fair Value Measurement . ASU 2018-13 resulted in certain modifications to fair value measurement disclosures, primarily related to level 3 fair value measurements. The new standard is effective for fiscal years, and interim periods within those fiscal years, beginning after December 15, 2019, and early adoption is permitted. The Company is currently evaluating the potential impact of the adoption of this standard on its disclosures. In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments – Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments . ASU 2016-03, in conjunction with ASU No. 2019-04, Codification Improvements to Topic 326, Financial Instruments - Credit Losses, Topic 815, Derivatives and Hedging, and Topic 825, Financial Instruments, introduces an approach, based on expected losses, to estimate credit losses on certain types of financial instruments and modifies the impairment model for available-for-sale debt securities. The new standard is effective for fiscal years, and interim periods within those fiscal years, beginning after December 15, 2019, and early adoption is permitted. The Company is currently evaluating the potential impact of the adoption of this standard on its results of operations, financial position and cash flows and related disclosures. In February 2016, the FASB issued ASU 2016-02, Leases (Topic 842) . The FASB issued the update to require the recognition of lease assets and liabilities on the balance sheet of lessees. The standard is effective for fiscal years beginning after December 15, 2018. The ASU requires a modified retrospective transition method with the option to elect a package of practical expedients. The Company adopted ASU 2016-02 on January 1, 2019 using the optional modified retrospective transition method and elected the following transition practical expedients: (i) to not reassess lease identification, lease classification and initial indirect costs related to those leases entered into prior to the adoption of ASC 842; and (ii) to not separate lease and non-lease components for our office lease portfolio. Refer to Note 6 — Leases for further details.

Inventory

Inventory	6 Months Ended
	Jun. 30, 2019
Inventory Disclosure [Abstract]
Inventory	Inventory Inventory consisted of the following: June 30, December 31, 2018 Raw materials $ 1,754 $ 1,969 Work-in-process 1,424 2,344 Finished goods 1,082 2,819 Total inventory $ 4,260 $ 7,132 Inventories are stated at the lower of cost or net realizable value, as determined on a first-in, first-out, basis.

Property and Equipment

Property and Equipment	6 Months Ended
	Jun. 30, 2019
Property, Plant and Equipment [Abstract]
Property and Equipment	Property and Equipment Property and equipment, net, consisted of: June 30, December 31, Computer equipment and software $ 1,063 $ 833 Furniture and fixtures 389 389 Machinery and equipment 3,137 2,723 Leasehold improvements 609 609 Construction in process 57 481 5,255 5,035 Less: accumulated depreciation (1,724 ) (1,151 ) $ 3,531 $ 3,884 Depreciation expense was $322 and $16 for the three months ended June 30, 2019 and 2018 , respectively. Depreciation expense was $591 and $172 for the six months ended June 30, 2019 and 2018 , respectively. In addition, depreciation expense of $42 and $76 was charged to inventory and prepaid expenses and other assets, respectively, as of June 30, 2019 , which represents depreciation expense related to equipment involved in the manufacturing process.

Leases

Leases	6 Months Ended
	Jun. 30, 2019
Leases [Abstract]
Leases	Leases In February 2016, the FASB issued ASU 2016-02, Leases (Topic 842) to require the recognition of lease assets and liabilities on the balance sheet of lessees. The Company implemented ASU 2016-02 as of January 1, 2019 using the optional modified retrospective transition method, which does not require the restatement of prior period amounts, and elected the following transition practical expedients: (i) to not reassess lease identification, lease classification and initial indirect costs related to those leases entered into prior to the adoption of ASC 842; and (ii) to not separate lease and non-lease components for our office lease portfolio. As of the implementation date, all of the Company's leases were operating leases and its total operating lease assets and liabilities were $2,411 and $2,887 , respectively. The Company leases office space, storage space and equipment (primarily vehicles). Certain office space leases include options to renew that generally can extend the lease term up to 3 years . The Company evaluates renewal options at lease inception and on an ongoing basis and includes renewal options that it is reasonably certain to exercise in its expected lease terms when classifying leases and measuring lease liabilities. Lease agreements generally do not require material variable lease payments, residual value guarantees or restrictive covenants. The table below presents the operating lease assets and liabilities recognized on the Company's consolidated balance sheets as of June 30, 2019 : Balance Sheet Line Item June 30, 2019 Non-current operating lease assets Other assets $ 2,110 Operating lease liabilities: Current operating lease liabilities Accrued expenses and other current liabilities 1,448 Non-current operating lease liabilities Other liabilities 864 Total operating lease liabilities $ 2,312 The depreciable lives of operating lease asset leasehold improvements are limited by the lease term. The Company's leases generally do not provide an implicit rate, and therefore, the Company uses its incremental borrowing rate as the discount rate when measuring operating leases liabilities. The incremental borrowing rate represents an estimate of the interest rate the Company would incur at lease commencement to borrow an amount equal to the lease payments on a collateralized basis over the term of a lease. The Company used the incremental borrowing rates as of January 1, 2019 for operating leases that commenced prior to that date. The Company's weighted average remaining lease term and weighted average discount rate for operating leases as of June 30, 2019 are: June 30, 2019 Weighted average remaining lease term (years) 1.63 Weighted average discount rate 5.96 % The table below reconciles the undiscounted future minimum lease payments (displayed in aggregate by year) under non-cancelable operating leases with terms of more than one year to the total operating lease liabilities recognized on the consolidated balance sheets as of June 30, 2019 : June 30, 2019 2019 $ 826 2020 1,152 2021 402 Thereafter — Total undiscounted future minimum lease payments 2,380 Less: difference between undiscounted lease payments and discounted operating lease liabilities 68 Total operating lease liabilities $ 2,312 Operating lease payments include $44 related to options to extend lease terms that are reasonably certain of being exercised. Operating lease costs were $690 and $1,069 for the three and six months ended June 30, 2019 , respectively. Operating lease costs are included within selling, general and administrative expenses on the consolidated statements of operations. Cash paid for amounts included in the measurement of operating lease liabilities were $688 for the six months ended June 30, 2019 , and this amount is included in operating activities in the consolidated statements of cash flows.

Accrued Expenses and Other Curr

Accrued Expenses and Other Current Liabilities	6 Months Ended
	Jun. 30, 2019
Payables and Accruals [Abstract]
Accrued Expenses and Other Current Liabilities	Accrued Expenses and Other Current Liabilities Accrued expenses and other current liabilities consisted of: June 30, December 31, Accrued expenses: Contract sales organization expenses $ 808 $ 4,482 Selling, general and administrative expenses 5,115 4,812 Research and development expenses 1,790 933 Payroll expenses 5,392 4,199 Product revenue allowances 6,633 2,856 Other 370 1,139 Total accrued expenses 20,108 18,421 Other current liabilities: Lease liability 1,448 — Total other current liabilities 1,448 — Total accrued expenses and other current liabilities $ 21,556 $ 18,421

License Agreements

License Agreements	6 Months Ended
	Jun. 30, 2019
Research and Development [Abstract]
License Agreements	License Agreements AVP-825 License Agreement In July 2013, the Company's wholly owned subsidiary, OptiNose AS, entered into the AVP-825 License Agreement with Avanir for the exclusive right to sell AVP-825 (now marketed as Onzetra ® Xsail ® ), a product combining a low-dose powder form of sumatriptan with the Company's EDS technology platform, for the acute treatment of migraines in adults and any follow-on products under development that consist of a formulation that contains triptans as the sole active ingredient. Through June 30, 2019 , under the terms of the AVP-825 License Agreement, the Company received aggregate cash payments of $70,000 in connection with the initial signing and the achievement of certain development milestones. The Company did not recognize any licensing revenue under the arrangement during the three and six months ended June 30, 2019 and 2018 and does not expect any future revenue under the AVP-825 License Agreement. On December 10, 2018, the Company received written notice from Avanir of its election to terminate the AVP-825 License Agreement. As a result, the AVP-825 License Agreement terminated on March 10, 2019. The Company is evaluating options with respect to the future of Onzetra Xsail. Inexia License Agreement On January 31, 2019, OptiNose AS, a wholly owned subsidiary of the Company, entered into the Inexia License Agreement with Inexia. Under the terms of the Inexia License Agreement, Inexia paid the Company a $500 upfront payment. For each product developed under the Inexia License Agreement, the Company is eligible to receive up to $8,000 of development milestone payments and up to $37,000 of sales milestone payments. In addition, the Company is eligible to receive tiered, low-to-mid single digit royalties based on net sales of any products successfully developed and commercialized under the Inexia License Agreement. Other than the upfront payment, the Company does not anticipate the receipt of any milestone or royalty payments from Inexia in the near term.

Long-Term Debt

Long-Term Debt	6 Months Ended
	Jun. 30, 2019
Debt Disclosure [Abstract]
Long-Term Debt	Long-term Debt On December 29, 2017, the Company entered into a Senior Secured Note Purchase Agreement (the Senior Secured Notes) with Athyrium Opportunities III Acquisition LP. The Senior Secured Notes provided the Company with up to $100,000 in capital, of which $75,000 in capital was issued immediately. The remaining $25,000 (the Delayed Draw Notes) was available to the Company between April 1, 2019 and August 14, 2019, subject to the Company achieving trailing four quarter net revenues (as calculated pursuant to the terms of the Senior Secured Note Purchase Agreement) of $15,000 and a pro forma ratio of total debt to trailing 12 month net revenues not exceeding 6.50 to 1.00 , and certain other conditions. While the Company has met the conditions necessary to issue the Delayed Draw Notes, the Company has elected not to draw the additional funding. The Senior Secured Notes bear interest at 9.0% plus the three-month London Inter-bank Offered Rate (LIBOR) rate, subject to a 1.0% floor and are scheduled to mature on June 29, 2023. The interest rate was 11.4375% at June 30, 2019 . The Senior Secured Notes bore front-end fees of 1.0% of the aggregate principal amount, which were paid at issuance. The Company is also required to pay an exit fee of 2.0% of any principal payments (whether mandatory, voluntary, or at maturity) made throughout the term of the Senior Secured Note Purchase Agreement. The Company may make voluntary prepayments of the Senior Secured Notes, in whole or in part, and subject to certain exceptions, is required to make mandatory prepayments upon the occurrence of certain events as defined in the agreement, including, the occurrence of a change of control. All mandatory and voluntary prepayments of the Senior Secured Notes are subject to the payment of prepayment premiums as follows: (i) if prepayment occurs prior to the second anniversary of the applicable date of issuance, an amount equal to the amount by which (a) the present value of 102% of the principal prepaid plus all interest that would have accrued on such principal through such second anniversary exceeds (b) the amount of principal prepaid, (ii) if prepayment occurs on or after the second anniversary of the applicable date of issuance but prior to the third anniversary of such issuance, an amount equal to 2% of the principal prepaid, and (iii) if prepayment occurs on or after the third anniversary of the applicable date of issuance but prior to the fourth anniversary of such issuance, an amount equal to 1% of the principal prepaid. No prepayment premium is due on any principal prepaid after the fourth anniversary of the applicable date of issuance of any Senior Secured Notes. The Company recorded interest expense of $2,389 and $2,301 during the three months ended June 30, 2019 and 2018 , respectively, and $4,777 and $4,494 during six months ended June 30, 2019 and 2018 , respectively, in conjunction with the Senior Secured Notes. Interest expense included total coupon interest, exit fees, front end fees and the amortization of debt issuance costs. The front-end fees of $1,000 were recorded as debt discount at issuance and are being amortized to interest expense over the 5.5 year term of the loan. Additionally, back end fees of $2,000 are being amortized to interest expense and are recorded as an increase in the carrying amount throughout the term of the Senior Secured Notes. The Company also incurred $2,181 in debt issuance costs during the year ended December 31, 2017, which are also being amortized to interest expense over the term of the Senior Secured Notes. The long-term debt balance is comprised of the following: June 30, December 31, Face amount $ 75,000 $ 75,000 Front end fees (799 ) (872 ) Debt issuance costs (1,742 ) (1,902 ) Back end fees 410 274 Long-term debt, net $ 72,869 $ 72,500

Employee Benefit Plans

Employee Benefit Plans	6 Months Ended
	Jun. 30, 2019
Retirement Benefits [Abstract]
Employee Benefit Plans	Employee Benefit Plans For US employees, the Company maintains a defined contribution 401(k) retirement plan. As of June 30, 2019 , approximately $117 is recorded in accrued liabilities related to the Company match. The Company's contributions are made in cash. For Norway and UK employees, the Company maintains defined contribution pension plans which meet the statutory requirements of those jurisdictions. The Company incurred costs related to the pension plans of $5 and $7 for the three months ended June 30, 2019 and 2018 , respectively, and $11 and $69 for the six months ended June 30, 2019 and 2018 , respectively.

Stockholders' Equity

Stockholders' Equity	6 Months Ended
	Jun. 30, 2019
Equity [Abstract]
Stockholders' Equity	Stockholders' Equity Common Stock On June 11, 2018, the Company and certain stockholders closed the Offering of 5,750,000 shares of Common Stock at a price of $22.25 per share. The Offering consisted of 2,875,000 shares of Common Stock sold by the Company and 2,875,000 shares of Common Stock sold by certain stockholders. As a result of the Offering, the Company received $59,917 in net proceeds, after deducting discounts and commissions of $3,678 and offering expenses of approximately $373 payable by the Company. Each share of Common Stock entitles the holder to one vote on all matters submitted to a vote of the Company’s stockholders. Subject to preferences that may apply to any outstanding preferred stock, holders of Common Stock are entitled to receive ratably any dividends that the Company’s board of directors may declare out of funds legally available for that purpose on a non-cumulative basis. No dividends had been declared through June 30, 2019 . Common Stock warrants As of June 30, 2019 , the Company had warrants outstanding to purchase 1,866,831 shares of Common Stock with an exercise price of $8.16 . The warrants expire on November 1, 2020.

Stock-based Compensation

Stock-based Compensation	6 Months Ended
	Jun. 30, 2019
Share-based Payment Arrangement [Abstract]
Stock-based Compensation	Stock-based Compensation The Company recorded stock-based compensation expense related to stock options and shares issued under the Company's 2017 Employee Stock Purchase Plan (2017 Plan) in the following expense categories of its accompanying consolidated statements of operations for the three and six months ended June 30, 2019 and 2018 : Three Months Ended June 30, Six Months Ended June 30, 2019 2018 2019 2018 Cost of product sales $ 26 $ 2 $ 45 $ 3 Research and development 284 166 527 405 General and administrative 2,387 1,932 4,545 3,715 $ 2,697 $ 2,100 $ 5,117 $ 4,123 In addition, stock-based compensation expense of $22 and $38 was charged to inventory and prepaid expenses and other assets, respectively, during the six months ended June 30, 2019 , which represents the total stock-based compensation expense incurred related to employees involved in the manufacturing process of finished goods and samples during the period. Stock Options The Company has issued serviced-based and performance-based stock options that generally have a contractual life of up to 10 years and may be exercisable in cash or as otherwise determined by the Company's board of directors. Vesting generally occurs over a period of not greater than four years. Performance-based options may vest upon the achievement of certain milestones in connection with the Company's development programs. Additionally, the Company has issued stock options in excess of the fair market value of Common Stock on the issuance date that were only exercisable upon a change in control or upon or after an initial public offering. As of June 30, 2019 , all of the performance conditions related to performance-based stock options issued by the Company have been achieved. The following table summarizes the activity related to stock option grants to employees and nonemployees for the six months ended June 30, 2019 : Shares Weighted average exercise price per share Weighted average remaining contractual life Outstanding at December 31, 2018 6,182,873 $ 10.60 6.67 Granted 2,013,173 7.73 Exercised (93,587 ) 3.98 Expired — — Forfeited (119,089 ) 11.34 Outstanding at June 30, 2019 7,983,370 $ 9.94 6.89 Exercisable at June 30, 2019 4,208,609 $ 9.07 5.01 Vested and expected to vest at June 30, 2019 7,983,370 $ 9.94 6.89 During the six months ended June 30, 2019 , stock options to purchase 2,013,173 shares of Common Stock were granted to employees and directors and generally vest over four years. The stock options had an estimated weighted average grant date fair value of $4.80 . During the six months ended June 30, 2018 , stock options to purchase 358,192 shares of Common Stock were granted to employees that generally vest over four years. The stock options had an estimated weighted average grant date fair value of $13.26 . The grant date fair value of each stock option grant was estimated at the time of grant using the Black-Scholes option-pricing model using the following weighted average assumptions: Six Months Ended June 30, 2019 2018 Risk free interest rate 2.51 % 2.69 % Expected term (in years) 6.05 5.90 Expected volatility 67.02 % 74.92 % Annual dividend yield 0.00 % 0.00 % Fair value of common stock $ 7.73 $ 19.98 The following table summarizes the activity related to restricted stock units (RSUs) granted to employees for the six months ended June 30, 2019 : Shares Balance at December 31, 2018 — Granted 20,600 Vested and settled — Expired/ forfeited/ canceled — Balance at June 30, 2019 20,600 Expected to vest at June 30, 2019 20,600 In April 2019, the Company granted 20,600 RSUs at a price of $10.20 , which vest over four years . At June 30, 2019 , the unrecognized compensation cost related to unvested stock options and RSUs expected to vest was $24,690 . This unrecognized compensation will be recognized over an estimated weighted-average amortization period of 2.76 years. 2017 Employee Stock Purchase Plan Under the 2017 Plan, shares of Common Stock may be purchased by eligible employees who elect to participate in the 2017 Plan at 85% of the lower of the fair market value of Common Stock on the first or last day of designated offering periods. The Company recognized stock-based compensation expense of $ 114 and $ 123 during the three months ended June 30, 2019 and 2018 , respectively, and $ 228 and $279 during the six months ended June 30, 2019 and 2018 , respectively, related to the 2017 Plan. The Company issued 53,137 and 31,892 shares of Common Stock related to the offering periods ended June 30, 2018 and December 31, 2018, respectively. The Company issued 77,909 shares of Common Stock related to the offering period ended June 30, 2019.

Basis of Presentation and Sum_2

Basis of Presentation and Summary of Significant Accounting Policies (Policies)	6 Months Ended
	Jun. 30, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Use of estimates	Use of estimates The preparation of the unaudited interim consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the unaudited interim consolidated financial statements and reported amounts of expenses during the reporting period. Due to the uncertainty of factors surrounding the estimates or judgments used in the preparation of the unaudited interim consolidated financial statements, actual results may materially vary from these estimates. Estimates and assumptions are periodically reviewed and the effects of revisions are reflected in the unaudited interim consolidated financial statements in the period they are determined to be necessary.
Concentration of credit risk	Concentration of credit risk Financial instruments that potentially subject the Company to concentrations of credit risk are primarily cash and accounts receivable. The Company generally invests its cash in deposits with high credit quality financial institutions. Additionally, the Company performs periodic evaluations of the relative credit standing of these financial institutions. The Company has exposure to credit risk in accounts receivable from sales of XHANCE. XHANCE is sold to wholesale pharmaceutical distributors and preferred pharmacy network partners (collectively, Customers), who, in turn, sell XHANCE to pharmacies, hospitals and other customers
Fair value of financial instruments	Fair value of financial instruments At June 30, 2019 and December 31, 2018 , the Company's financial instruments included cash and cash equivalents, accounts receivable, grants receivable, inventory, accounts payable and accrued expenses. The carrying amounts reported in the Company's financial statements for these instruments approximate their respective fair values because of the short-term nature of these instruments. The Company also believes the carrying value of long-term debt approximates fair value at June 30, 2019 as the interest rates are reflective of the rate the Company could obtain on debt with similar terms and conditions.
Restricted cash	Restricted cash As of June 30, 2019 and December 31, 2018 , the restricted cash balance included in prepaid expenses and other assets was $15 and $20 , respectively.
Net Product Revenues and Licensing revenues	Net Product Revenues The Company accounts for revenue in accordance with ASC Topic 606, Revenue from Contracts with Customers , which was adopted on January 1, 2018. The Company recognizes revenue from XHANCE sales at the point the Customer obtains control of the product, which generally occurs upon delivery. The transaction price that is recognized as revenue for products includes an estimate of variable consideration. The Company’s estimates of variable consideration and determination of whether to include estimated amounts in the transaction price are based largely on an assessment of its anticipated performance and all information (historical, current and forecasted) that is reasonably available. The components of the Company’s variable consideration include the following: Provider Chargebacks and Discounts. Chargebacks for fees and discounts to providers represent the estimated obligations resulting from contractual commitments to sell products to qualified healthcare providers at prices lower than the list prices charged to Customers who directly purchase the product from the Company. Customers charge the Company for the difference between what they pay for the product and the ultimate selling price to the qualified healthcare providers. These components of variable consideration are established in the same period that the related revenue is recognized, resulting in a reduction of product revenue and accounts receivable. Trade Discounts and Allowances. The Company generally provides Customers with discounts that include incentive fees which are explicitly stated in the Company’s contracts. These discounts are recorded as a reduction of revenue and accounts receivable in the period in which the related product revenue is recognized. In addition, the Company reimburses (through discounts and allowances) its Customers for sales order management, data and distribution services. Product Returns. Consistent with industry practice, the Company has a product returns policy that provides Customers a right of return for product purchased within a specified period prior to and subsequent to the product’s expiration date. The Company estimates the amount of its product that may be returned and presents this amount as a reduction of revenue in the period the related product revenue is recognized, in addition to establishing a liability. The Company considers several factors in the estimation process, including expiration dates of product shipped to preferred pharmacy network partners and wholesalers, inventory levels within the distribution channel, product shelf life, prescription trends and other relevant factors. Government Rebates. The Company is subject to discount obligations under state Medicaid programs and Medicare. These reserves are recorded in the same period the related revenue is recognized, resulting in a reduction of product revenue and the establishment of a current liability. The Company’s liability for these rebates consists of estimates of claims for the current quarter and estimated future claims that will be made for product that has been recognized as revenue but remains in the distribution channel inventories at the end of the reporting period. Payor Rebates. The Company contracts with certain third-party payors, primarily health insurance companies and pharmacy benefit managers, for the payment of rebates with respect to utilization of its products. These rebates are based on contractual percentages applied to the amount of product prescribed to patients who are covered by the plan or the organization with which it contracts. The Company estimates these rebates and records such estimates in the same period the related revenue is recognized, resulting in a reduction of product revenue and the establishment of a current liability. Other Incentives. Other incentives that the Company offers include voluntary patient assistance programs, such as co-pay assistance programs, which are intended to provide financial assistance to qualified commercially insured patients with prescription drug co-payments required by payors and coupon programs for cash payors. The calculation of the accruals for this assistance is based on an estimate of claims and the cost per claim that the Company expects to receive associated with product that has been recognized as revenue but remains in the distribution channel inventories at the end of each reporting period. Licensing revenues During the six months ended June 30, 2019 , the Company's licensing revenues were generated pursuant to the terms of a single license agreement (the Inexia License Agreement) with Inexia Limited (Inexia) (Note 8). The Inexia License Agreement includes licensed rights to patented technology, a non-refundable up-front payment, development and sales milestones as well as royalty payments. The Company analyzed the performance obligations under the Inexia License Agreement, the consideration received to date and the consideration the Company could receive in the future as part of its analysis related to ASC 606.
Net income (loss) per common share	Net income (loss) per common share Basic net income (loss) per common share is determined by dividing net income (loss) applicable to Common Stock holders by the weighted average common shares outstanding during the period. For the three and six months ended June 30, 2019 and 2018 , the outstanding Common Stock options, Common Stock warrants and shares to be issued under the Company's 2017 Employee Stock Purchase Plan have been excluded from the calculation of diluted net loss per share because their effect would be anti-dilutive. Therefore, the weighted average shares used to calculate both basic and diluted net loss per share are the same.
Income taxes	Income taxes In accordance with ASC 270, Interim Reporting , and ASC 740, Income Taxes , the Company is required at the end of each interim period to determine the best estimate of its annual effective tax rate and then apply that rate in providing for income taxes on a current year-to-date (interim period) basis. For the three and six months ended June 30, 2019 and 2018 , the Company recorded no tax expense or benefit due to the expected current year loss and its historical losses. As of June 30, 2019 and December 31, 2018 , the Company has concluded that a full valuation allowance is necessary for all of its net deferred tax assets. The Company had no amounts recorded for uncertain tax positions, interest or penalties in the accompanying consolidated financial statements.
Recent accounting pronouncements	Recent accounting pronouncements In August 2018, the FASB issued ASU No. 2018-15, Customer's Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract . ASU 2018-15 requires that certain implementation costs incurred in a cloud computing arrangement be deferred and recognized over the term of the arrangement. The new standard is effective for fiscal years, and interim periods within those fiscal years, beginning after December 15, 2019, and early adoption is permitted. The Company is currently evaluating the potential impact of the adoption of this standard on its results of operations, financial position and cash flows and related disclosures. In August 2018, the FASB issued ASU No. 2018-13, Disclosure Framework - Changes to the Disclosure Requirements for Fair Value Measurement . ASU 2018-13 resulted in certain modifications to fair value measurement disclosures, primarily related to level 3 fair value measurements. The new standard is effective for fiscal years, and interim periods within those fiscal years, beginning after December 15, 2019, and early adoption is permitted. The Company is currently evaluating the potential impact of the adoption of this standard on its disclosures. In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments – Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments . ASU 2016-03, in conjunction with ASU No. 2019-04, Codification Improvements to Topic 326, Financial Instruments - Credit Losses, Topic 815, Derivatives and Hedging, and Topic 825, Financial Instruments, introduces an approach, based on expected losses, to estimate credit losses on certain types of financial instruments and modifies the impairment model for available-for-sale debt securities. The new standard is effective for fiscal years, and interim periods within those fiscal years, beginning after December 15, 2019, and early adoption is permitted. The Company is currently evaluating the potential impact of the adoption of this standard on its results of operations, financial position and cash flows and related disclosures. In February 2016, the FASB issued ASU 2016-02, Leases (Topic 842) . The FASB issued the update to require the recognition of lease assets and liabilities on the balance sheet of lessees. The standard is effective for fiscal years beginning after December 15, 2018. The ASU requires a modified retrospective transition method with the option to elect a package of practical expedients. The Company adopted ASU 2016-02 on January 1, 2019 using the optional modified retrospective transition method and elected the following transition practical expedients: (i) to not reassess lease identification, lease classification and initial indirect costs related to those leases entered into prior to the adoption of ASC 842; and (ii) to not separate lease and non-lease components for our office lease portfolio. Refer to Note 6 — Leases for further details.

Basis of Presentation and Sum_3

Basis of Presentation and Summary of Significant Accounting Policies (Tables)	6 Months Ended
	Jun. 30, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Schedule of Antidilutive Shares Excluded From Computation of Net Loss Per Share	Diluted net loss per common share for the periods presented do not reflect the following potential common shares, as the effect would be antidilutive: June 30, 2019 2018 Stock options 7,983,370 6,126,560 Common stock warrants 1,866,831 1,878,660 Employee stock purchase plan — 53,137 Total 9,850,201 8,058,357

Inventory (Tables)

Inventory (Tables)	6 Months Ended
	Jun. 30, 2019
Inventory Disclosure [Abstract]
Schedule of Inventory	Inventory consisted of the following: June 30, December 31, 2018 Raw materials $ 1,754 $ 1,969 Work-in-process 1,424 2,344 Finished goods 1,082 2,819 Total inventory $ 4,260 $ 7,132

Property and Equipment (Tables)

Property and Equipment (Tables)	6 Months Ended
	Jun. 30, 2019
Property, Plant and Equipment [Abstract]
Schedule of Property and Equipment	Property and equipment, net, consisted of: June 30, December 31, Computer equipment and software $ 1,063 $ 833 Furniture and fixtures 389 389 Machinery and equipment 3,137 2,723 Leasehold improvements 609 609 Construction in process 57 481 5,255 5,035 Less: accumulated depreciation (1,724 ) (1,151 ) $ 3,531 $ 3,884

Leases (Tables)

Leases (Tables)	6 Months Ended
	Jun. 30, 2019
Leases [Abstract]
Assets And Liabilities	The table below presents the operating lease assets and liabilities recognized on the Company's consolidated balance sheets as of June 30, 2019 : Balance Sheet Line Item June 30, 2019 Non-current operating lease assets Other assets $ 2,110 Operating lease liabilities: Current operating lease liabilities Accrued expenses and other current liabilities 1,448 Non-current operating lease liabilities Other liabilities 864 Total operating lease liabilities $ 2,312 The Company's weighted average remaining lease term and weighted average discount rate for operating leases as of June 30, 2019 are: June 30, 2019 Weighted average remaining lease term (years) 1.63 Weighted average discount rate 5.96 %
Operating Lease, Liability, Maturity	The table below reconciles the undiscounted future minimum lease payments (displayed in aggregate by year) under non-cancelable operating leases with terms of more than one year to the total operating lease liabilities recognized on the consolidated balance sheets as of June 30, 2019 : June 30, 2019 2019 $ 826 2020 1,152 2021 402 Thereafter — Total undiscounted future minimum lease payments 2,380 Less: difference between undiscounted lease payments and discounted operating lease liabilities 68 Total operating lease liabilities $ 2,312

Accrued Expenses and Other Cu_2

Accrued Expenses and Other Current Liabilities (Tables)	6 Months Ended
	Jun. 30, 2019
Payables and Accruals [Abstract]
Schedule of Accrued Expenses and Other Current Liabilities	Accrued expenses and other current liabilities consisted of: June 30, December 31, Accrued expenses: Contract sales organization expenses $ 808 $ 4,482 Selling, general and administrative expenses 5,115 4,812 Research and development expenses 1,790 933 Payroll expenses 5,392 4,199 Product revenue allowances 6,633 2,856 Other 370 1,139 Total accrued expenses 20,108 18,421 Other current liabilities: Lease liability 1,448 — Total other current liabilities 1,448 — Total accrued expenses and other current liabilities $ 21,556 $ 18,421

Long-Term Debt (Tables)

Long-Term Debt (Tables)	6 Months Ended
	Jun. 30, 2019
Debt Disclosure [Abstract]
Schedule of Long-term Debt Instruments	The long-term debt balance is comprised of the following: June 30, December 31, Face amount $ 75,000 $ 75,000 Front end fees (799 ) (872 ) Debt issuance costs (1,742 ) (1,902 ) Back end fees 410 274 Long-term debt, net $ 72,869 $ 72,500

Stock-based Compensation (Table

Stock-based Compensation (Tables)	6 Months Ended
	Jun. 30, 2019
Share-based Payment Arrangement [Abstract]
Schedule of Allocated Stock-Based Compensation Expense	The Company recorded stock-based compensation expense related to stock options and shares issued under the Company's 2017 Employee Stock Purchase Plan (2017 Plan) in the following expense categories of its accompanying consolidated statements of operations for the three and six months ended June 30, 2019 and 2018 : Three Months Ended June 30, Six Months Ended June 30, 2019 2018 2019 2018 Cost of product sales $ 26 $ 2 $ 45 $ 3 Research and development 284 166 527 405 General and administrative 2,387 1,932 4,545 3,715 $ 2,697 $ 2,100 $ 5,117 $ 4,123
Schedule of Stock Option Activity	The following table summarizes the activity related to stock option grants to employees and nonemployees for the six months ended June 30, 2019 : Shares Weighted average exercise price per share Weighted average remaining contractual life Outstanding at December 31, 2018 6,182,873 $ 10.60 6.67 Granted 2,013,173 7.73 Exercised (93,587 ) 3.98 Expired — — Forfeited (119,089 ) 11.34 Outstanding at June 30, 2019 7,983,370 $ 9.94 6.89 Exercisable at June 30, 2019 4,208,609 $ 9.07 5.01 Vested and expected to vest at June 30, 2019 7,983,370 $ 9.94 6.89
Schedule of Fair Value Options using Black-Scholes Pricing Model	The grant date fair value of each stock option grant was estimated at the time of grant using the Black-Scholes option-pricing model using the following weighted average assumptions: Six Months Ended June 30, 2019 2018 Risk free interest rate 2.51 % 2.69 % Expected term (in years) 6.05 5.90 Expected volatility 67.02 % 74.92 % Annual dividend yield 0.00 % 0.00 % Fair value of common stock $ 7.73 $ 19.98
Schedule of Nonvested Restricted Stock Units Activity	The following table summarizes the activity related to restricted stock units (RSUs) granted to employees for the six months ended June 30, 2019 : Shares Balance at December 31, 2018 — Granted 20,600 Vested and settled — Expired/ forfeited/ canceled — Balance at June 30, 2019 20,600 Expected to vest at June 30, 2019 20,600

Liquidity (Details)

Liquidity (Details) - USD ($) $ / shares in Units, $ in Thousands	Jun. 11, 2018	Jun. 30, 2019	Dec. 31, 2018
Subsidiary, Sale of Stock [Line Items]
Cash and cash equivalents		$ 143,963	$ 200,990
Public Offering
Subsidiary, Sale of Stock [Line Items]
Number of shares issued (in shares)	5,750,000
Price per share (usd per share)	$ 22.25
Consideration received on transaction	$ 59,917
Discounts and commissions	3,678
Offering expenses payable	$ 373
The Company | Public Offering
Subsidiary, Sale of Stock [Line Items]
Number of shares issued (in shares)	2,875,000
Certain Stockholders | Public Offering
Subsidiary, Sale of Stock [Line Items]
Number of shares issued (in shares)	2,875,000

Basis of Presentation and Sum_4

Basis of Presentation and Summary of Significant Accounting Policies - Concentration of Credit Risk (Details) - Customer Concentration Risk	3 Months Ended	6 Months Ended
	Jun. 30, 2019customer	Jun. 30, 2019customer
Accounts Receivable
Concentration Risk [Line Items]
Number of customers	5	5
Concentration risk (as a percent)		68.00%
Sales Revenue, Net
Concentration Risk [Line Items]
Number of customers	5	5
Concentration risk (as a percent)	67.00%	68.00%

Basis of Presentation and Sum_5

Basis of Presentation and Summary of Significant Accounting Policies - Restricted Cash (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Prepaid Expenses and Other Current Assets
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Restricted cash	$ 15	$ 20

Basis of Presentation and Sum_6

Basis of Presentation and Summary of Significant Accounting Policies - Licensing (Details) $ in Thousands	6 Months Ended
	Jun. 30, 2019USD ($)
License Agreement Terms
Research and Development Arrangement, Contract to Perform for Others [Line Items]
Upfront payment received	$ 500

Basis of Presentation and Sum_7

Basis of Presentation and Summary of Significant Accounting Policies - Antidilutive Shares Excluded From Computation of Net Loss Per Share (Details) - shares	6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Securites excluded from computation of net loss per common share	9,850,201	8,058,357
Stock options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Securites excluded from computation of net loss per common share	7,983,370	6,126,560
Common stock warrants
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Securites excluded from computation of net loss per common share	1,866,831	1,878,660
Employee stock purchase plan
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Securites excluded from computation of net loss per common share	0	53,137

Inventory (Details)

Inventory (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Inventory Disclosure [Abstract]
Raw materials	$ 1,754	$ 1,969
Work-in-process	1,424	2,344
Finished goods	1,082	2,819
Total inventory	$ 4,260	$ 7,132

Property and Equipment - Proper

Property and Equipment - Property and Equipment (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 5,255	$ 5,035
Less: accumulated depreciation	(1,724)	(1,151)
Property and equipment, net	3,531	3,884
Computer equipment and software
Property, Plant and Equipment [Line Items]
Property and equipment, gross	1,063	833
Furniture and fixtures
Property, Plant and Equipment [Line Items]
Property and equipment, gross	389	389
Machinery and equipment
Property, Plant and Equipment [Line Items]
Property and equipment, gross	3,137	2,723
Leasehold improvements
Property, Plant and Equipment [Line Items]
Property and equipment, gross	609	609
Construction in process
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 57	$ 481

Property and Equipment - Narrat

Property and Equipment - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018	Dec. 31, 2018
Property, Plant and Equipment [Line Items]
Depreciation	$ 322	$ 16	$ 591	$ 172
Accumulated depreciation	1,724		1,724		$ 1,151
Inventory
Property, Plant and Equipment [Line Items]
Accumulated depreciation	76		76
Prepaid expenses and other assets
Property, Plant and Equipment [Line Items]
Accumulated depreciation	$ 42		$ 42

Leases - Narrative (Details)

Leases - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended	6 Months Ended
	Jun. 30, 2019	Jun. 30, 2019	Jan. 01, 2019
Leases [Abstract]
Operating lease assets			$ 2,411
Operating lease liabilities	$ 2,312	$ 2,312	$ 2,887
Option to renew, extension of lease term	3 years	3 years
Operating lease payments related to options to extend lease terms		$ 44
Operating lease costs	$ 690	$ 1,069
Cash paid for amounts included in the measurement of operating lease liabilities	$ 688

Leases - Operating Lease Assets

Leases - Operating Lease Assets and Liabilities (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Jan. 01, 2019	Dec. 31, 2018
Leases [Abstract]
Non-current operating lease assets	$ 2,110
Current operating lease liabilities	1,448		$ 0
Non-current operating lease liabilities	864
Total operating lease liabilities	$ 2,312	$ 2,887

Leases - Weighted Average Remai

Leases - Weighted Average Remaining Lease Term and Weighted Average Discount Rate (Details)	Jun. 30, 2019
Leases [Abstract]
Weighted average remaining lease term (years)	1 year 7 months 17 days
Weighted average discount rate	5.96%

Leases - Operating Lease Maturi

Leases - Operating Lease Maturities (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Jan. 01, 2019
Operating leases
2019	$ 826
2020	1,152
2021	402
Thereafter	0
Total undiscounted future minimum lease payments	2,380
Less: difference between undiscounted lease payments and discounted operating lease liabilities	68
Total operating lease liabilities	$ 2,312	$ 2,887

Accrued Expenses and Other Cu_3

Accrued Expenses and Other Current Liabilities (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Accrued expenses:
Contract sales organization expenses	$ 808	$ 4,482
Selling, general and administrative expenses	5,115	4,812
Research and development expenses	1,790	933
Payroll expenses	5,392	4,199
Product revenue allowances	6,633	2,856
Other	370	1,139
Total accrued expenses	20,108	18,421
Other current liabilities:
Lease liability	1,448	0
Total other current liabilities	1,448	0
Total accrued expenses and other current liabilities	$ 21,556	$ 18,421

License Agreements (Details)

License Agreements (Details) - License Agreement Terms - USD ($)	Jan. 31, 2019	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2019
Research and Development Arrangement, Contract to Perform for Others [Line Items]
Aggregate cash payments received from license agreement					$ 70,000,000
Licensing revenue		$ 0	$ 0
Upfront payment received				$ 500,000
Development milestone payments eligible to be received (up to)	$ 8,000,000
Sales milestone payments eligible to be received (up to)	$ 37,000,000

Long-Term Debt - Narrative (Det

Long-Term Debt - Narrative (Details)	Dec. 29, 2017USD ($)	Jun. 30, 2019USD ($)	Jun. 30, 2018USD ($)	Jun. 30, 2019USD ($)	Jun. 30, 2018USD ($)	Dec. 31, 2018USD ($)	Dec. 31, 2017USD ($)
Debt Instrument [Line Items]
Revenues		$ 6,677,000	$ 1,274,000	$ 11,153,000	$ 2,139,000
Interest expense amortization period				5 years 6 months
Interest expense, back end fees				$ 2,000,000
Debt issuance costs							$ 2,181,000
Senior Notes
Debt Instrument [Line Items]
Interest expense, front end fees				1,000,000
Senior Notes | Note Purchase Agreement
Debt Instrument [Line Items]
Unused borrowing capacity, amount	$ 100,000,000
Face amount	$ 75,000,000	$ 75,000,000		$ 75,000,000		$ 75,000,000
Stated interest rate	9.00%	11.4375%		11.4375%
Upfront fee (as a percent)	1.00%
Exit fee (as a percent)	2.00%
Prepayment, prior to second anniversary	102.00%
Prepayment fee, after second and before third anniversary	2.00%
Prepayment fee, after third and before fourth anniversary	1.00%
Interest expense		$ 2,389,000	$ 2,301,000	$ 4,777,000	$ 4,494,000
Senior Notes | Note Purchase Agreement | London Interbank Offered Rate (LIBOR)
Debt Instrument [Line Items]
Interest rate floor (as a percent)	1.00%
Senior Notes | Note Purchase Agreement - Delayed Draw Notes
Debt Instrument [Line Items]
Unused borrowing capacity, amount	$ 25,000,000
Revenues	$ 15,000,000
Total debt to trailing four quarter net revenues	6.50

Long-Term Debt - Schedule of Lo

Long-Term Debt - Schedule of Long Term Debt (Details) - USD ($)	Jun. 30, 2019	Dec. 31, 2018	Dec. 29, 2017
Debt Instrument [Line Items]
Long-term debt, net	$ 72,869,000	$ 72,500,000
Note Purchase Agreement | Senior Notes
Debt Instrument [Line Items]
Face amount	75,000,000	75,000,000	$ 75,000,000
Front end fees	(799,000)	(872,000)
Debt issuance costs	(1,742,000)	(1,902,000)
Back end fees	410,000	274,000
Long-term debt, net	$ 72,869,000	$ 72,500,000

Employee Benefit Plans (Details

Employee Benefit Plans (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Defined Contribution Plan Disclosure [Line Items]
Defined contribution plan, cost			$ 117
Norway and UK employee plans
Defined Contribution Plan Disclosure [Line Items]
Defined contribution plan, cost	$ 5	$ 7	$ 11	$ 69

Stockholders' Equity (Details)

Stockholders' Equity (Details) $ / shares in Units, $ in Thousands	Jun. 11, 2018USD ($)$ / sharesshares	Jun. 30, 2019vote$ / sharesshares
Class of Stock [Line Items]
Number of votes per share | vote		1
Dividends declared (usd per share) | $ / shares		$ 0
Common stock warrants outstanding (in shares)		1,866,831
Common stock warrant exercise price (usd per share) | $ / shares		$ 8.16
Public Offering
Class of Stock [Line Items]
Number of shares issued (in shares)	5,750,000
Price per share (usd per share) | $ / shares	$ 22.25
Net proceeds received | $	$ 59,917
Discounts and commissions | $	3,678
Offering expenses payable | $	$ 373
The Company | Public Offering
Class of Stock [Line Items]
Number of shares issued (in shares)	2,875,000
Certain Stockholders | Public Offering
Class of Stock [Line Items]
Number of shares issued (in shares)	2,875,000

Stock-based Compensation - Allo

Stock-based Compensation - Allocated Stock-Based Compensation Expense (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Stock-based compensation expense	$ 2,697	$ 2,100	$ 5,117	$ 4,123
Cost of product sales
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Stock-based compensation expense	26	2	45	3
Research and development
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Stock-based compensation expense	284	166	527	405
General and administrative
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Stock-based compensation expense	$ 2,387	$ 1,932	$ 4,545	$ 3,715

Stock-based Compensation - Narr

Stock-based Compensation - Narrative (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		6 Months Ended		66 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018	Dec. 31, 2018
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 2,697	$ 2,100	$ 5,117	$ 4,123
Plan options contractual life (up to)			10 years
Award vesting period			4 years
Unrecognized compensation cost	24,690		$ 24,690
Estimated weighted-average amortization period			2 years 9 months 4 days
Service Based Stock Options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period			4 years	4 years
Stock options to purchase shares (in shares)			2,013,173	358,192
Weighted average grant date fair value (usd per share)			$ 4.80	$ 13.26
Restricted Stock Units (RSUs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period			4 years
Granted (in shares)			20,600
Restricted shares fair value at grant date (usd per share)			$ 10.20
2017 Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 114	$ 123	$ 228	$ 279
Shares issued (in shares)			77,909	53,137	31,892
Inventory
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense			$ 22
Prepaid expenses and other assets
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense			$ 38

Stock-based Compensation - Stoc

Stock-based Compensation - Stock Option Activity (Details) - Service Based Stock Options - $ / shares	6 Months Ended		12 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Dec. 31, 2018
Shares
Beginning balance (in shares)	6,182,873
Granted (in shares)	2,013,173	358,192
Exercised (in shares)	(93,587)
Expired (in shares)	0
Forfeited (in shares)	(119,089)
Ending balance (in shares)	7,983,370		6,182,873
Exercisable (in shares)	4,208,609
Vested and expected to vest (in shares)	7,983,370
Weighted average exercise price per share
Beginning balance (usd per share)	$ 10.60
Granted (usd per share)	7.73
Exercised (usd per share)	3.98
Expired (usd per share)	0
Forfeited (usd per share)	11.34
Ending balance (usd per share)	9.94		$ 10.60
Exercisable (usd per share)	9.07
Vested and expected to vest (usd per share)	$ 9.94
Weighted average remaining contractual life
Options outstanding, Weighted average remaining contractual life	6 years 10 months 20 days		6 years 8 months 1 day
Options exercisable, Weighted average remaining contractual life	5 years 5 days
Vested and expected to vest, Weighted average remaining contractual life	6 years 10 months 20 days

Stock-based Compensation - Fair

Stock-based Compensation - Fair Value Options using Black-Scholed Pricing Model (Details) - Stock options - $ / shares	6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Risk free interest rate	2.51%	2.69%
Expected term (in years)	6 years 18 days	5 years 10 months 25 days
Expected volatility	67.02%	74.92%
Annual dividend yield	0.00%	0.00%
Fair value of common stock (usd per share)	$ 7.73	$ 19.98

Stock-based Compensation - Rest

Stock-based Compensation - Restricted Stock Units Activity (Details) - Restricted Stock Units (RSUs)	6 Months Ended
	Jun. 30, 2019shares
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Number of Shares [Roll Forward]
Balance at December 31, 2018 (in shares)	0
Granted (in shares)	20,600
Vested and settled (in shares)	0
Expired/ forfeited/ canceled (in shares)	0
Balance at June 30, 2019 (in shares)	20,600
Expected to vest at June 30, 2019 (in shares)	20,600