Product Revenue, Net | 3. PRODUCT REVENUE, NET To date, the Company’s only source of product revenue has been from the sales of RELYVRIO, known as ALBRIOZA in Canada. Significant judgment is required in estimating GTN adjustments considering historical experience, payer channel mix (e.g., Medicare or Medicaid), current contract prices under applicable programs, unbilled claims and processing time lags and inventory levels in the distribution channel. The following table reconciles gross product revenue to net product revenue (in thousands): Three Months Ended March 31, 2024 2023 Product revenue, gross $ 113,660 $ 84,553 GTN adjustments ( 25,017 ) ( 13,125 ) Product revenue, net $ 88,643 $ 71,428 The activity and ending reserve balance for GTN adjustments were as follows for the three months ended March 31, 2024 and 2023 (in thousands): Chargebacks and Cash Discounts Medicaid and Medicare Rebates Other Rebates, Returns, Discounts and Adjustments Total Ending balance at December 31, 2023 $ 3,143 $ 4,946 $ 11,073 $ 19,162 Provision related to sales in the current year 4,983 3,504 19,288 27,775 Adjustments related to prior period sales ( 1,696 ) — ( 1,062 ) ( 2,758 ) Credits and payments made ( 5,784 ) ( 2,201 ) ( 5,246 ) ( 13,231 ) Ending balance at March 31, 2024 $ 646 $ 6,249 $ 24,053 $ 30,948 Chargebacks and Cash Discounts Medicaid and Medicare Rebates Other Rebates, Returns, Discounts and Adjustments Total Ending balance at December 31, 2022 $ 648 $ 1,992 $ 1,664 $ 4,304 Provision related to sales in the current year 6,273 3,640 3,448 13,361 Adjustments related to prior period sales — ( 236 ) — ( 236 ) Credits and payments made ( 2,907 ) ( 718 ) ( 2,422 ) ( 6,047 ) Ending balance at March 31, 2023 $ 4,014 $ 4,678 $ 2,690 $ 11,382 Included in the ending reserve balance for GTN adjustments are chargebacks 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, discounts to customers for prompt payment and estimates for product returns. Chargebacks, discounts and returns are recorded as reductions of accounts receivable, net on the condensed consolidated balance sheets. In addition, included in the ending reserve balance for GTN adjustments are Medicaid and Medicare rebates, other rebates for obligations under voluntary patient assistance programs, and accrued fees payable to customers. Medicaid and Medicare rebates, other rebates and fees are recorded as a component of accrued expenses on the condensed consolidated balance sheets. In April 2024, the Company announced it started a process with the FDA and Health Canada to voluntarily discontinue the marketing authorizations for RELYVRIO ® /ALBRIOZA and remove the product from the market in the U.S. and Canada based on topline results from the Phase 3 PHOENIX trial . |