Krystal Biotech (KRYS) 10-Q 6 May 24 2024 Q1 Quarterly report Financial data

Cover

Cover - shares	3 Months Ended
	Mar. 31, 2024	Apr. 29, 2024
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2024
Document Transition Report	false
Entity File Number	001-38210
Entity Registrant Name	Krystal Biotech, Inc.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	82-1080209
Entity Address, Address Line One	2100 Wharton Street
Entity Address, Address Line Two	Suite 701
Entity Address, City or Town	Pittsburgh
Entity Address, State or Province	PA
Entity Address, Postal Zip Code	15203
City Area Code	412
Local Phone Number	586-5830
Title of 12(b) Security	Common Stock
Trading Symbol	KRYS
Security Exchange Name	NASDAQ
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
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		28,558,440
Amendment Flag	false
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q1
Entity Central Index Key	0001711279
Current Fiscal Year End Date	--12-31

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets (unaudited) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Current assets
Cash and cash equivalents	$ 359,006	$ 358,328
Short-term investments	179,253	173,850
Accounts receivable, net	46,467	42,040
Inventory	11,037	6,985
Prepaid expenses and other current assets	6,485	6,706
Total current assets	602,248	587,909
Property and equipment, net	160,011	161,202
Long-term investments	83,996	61,954
Right-of-use assets	6,845	7,027
Other non-current assets	196	263
Total assets	853,296	818,355
Current liabilities
Accounts payable	5,359	4,132
Current portion of lease liability	1,430	1,474
Accrued rebates	11,289	5,977
Accrued expenses and other current liabilities	29,511	21,511
Total current liabilities	47,589	33,094
Lease liability	6,465	6,620
Total liabilities	54,054	39,714
Commitments and contingencies (see note 7)
Stockholders' equity
Common stock; $0.00001 par value; 80,000 shares authorized as of March 31, 2024 and December 31, 2023; 28,528 and 28,237 shares issued and outstanding as of March 31, 2024 and December 31, 2023, respectively.	0	0
Additional paid-in capital	1,068,436	1,047,830
Accumulated other comprehensive (loss) gain	(299)	638
Accumulated deficit	(268,895)	(269,827)
Total stockholders’ equity	799,242	778,641
Total liabilities and stockholders’ equity	$ 853,296	$ 818,355

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (unaudited) (Parenthetical) - $ / shares	Mar. 31, 2024	Dec. 31, 2023
Statement of Financial Position [Abstract]
Common stock, par value (in dollars per share)	$ 0.00001	$ 0.00001
Common stock, shares authorized	80,000,000	80,000,000
Common stock, shares issued	28,528,000	28,237,000
Common stock, shares outstanding	28,528,000	28,237,000

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations and Comprehensive Loss (unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024		Mar. 31, 2023
Income Statement [Abstract]
Revenue from Contract with Customer, Product and Service [Extensible Enumeration]	Product [Member]		Product [Member]
Product revenue, net	$ 45,250		$ 0
Expenses
Cost, Product and Service [Extensible Enumeration]	Product [Member]		Product [Member]
Cost of goods sold	$ 2,419		$ 0
Research and development	10,957		12,288
Selling, general, and administrative	26,058		24,035
Litigation settlement	12,500		12,500
Total operating expenses	51,934		48,823
Loss from operations	(6,684)		(48,823)
Other income
Interest and other income, net	7,616		3,526
Net income (loss)	932		(45,297)
Unrealized (loss) gain on available-for-sale securities and other	(937)	[1]	574
Comprehensive loss	$ (5)		$ (44,723)
Net income (loss) per common share: basic (in dollars per share)	$ 0.03		$ (1.76)
Net income (loss) per common share: diluted (in dollars per share)	$ 0.03		$ (1.76)
Weighted-average common shares outstanding: basic (in shares)	28,295,000		25,712,000
Weighted-average common shares outstanding: diluted (in shares)	29,291,000		25,712,000
[1] Includes foreign currency translation losses of $62 thousand and $35 thousand for the three months ended March 31, 2024 and 2023, respectively.

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Stockholders' Equity (unaudited) - USD ($) $ in Thousands		Total	Common Stock	Additional Paid-in Capital	Accumulated Other Comprehensive (Loss)		Accumulated Deficit
Beginning balance (in shares) at Dec. 31, 2022			25,764,000
Beginning balance at Dec. 31, 2022		$ 522,231	$ 0	$ 803,718	$ (728)		$ (280,759)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock, net, (in shares)			42,000
Issuance of common stock upon exercise of stock options, net		2,208		2,208
Shares surrendered for taxes and forfeitures (in shares)			(10,000)
Shares of restricted stock awards surrendered for taxes		(749)		(749)
Stock-based compensation		10,599		10,599
Unrealized gain (loss) on investments and other		574			574	[1]
Net income (loss)		(45,297)					(45,297)
Ending balance (in shares) at Mar. 31, 2023			25,796,000
Ending balance at Mar. 31, 2023		489,566	$ 0	815,776	(154)		(326,056)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Foreign currency translation loss		35
Beginning balance (in shares) at Dec. 31, 2023			28,237,000
Beginning balance at Dec. 31, 2023		778,641	$ 0	1,047,830	638		(269,827)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock, net, (in shares)			260,000
Issuance of common stock upon exercise of stock options, net		15,969		15,969
Vesting of restricted stock units, net of shares withheld for taxes (in shares)			39,000
Vesting of restricted stock units, net of shares withheld for taxes		(4,181)		(4,181)
Shares surrendered for taxes and forfeitures (in shares)			(8,000)
Shares of restricted stock awards surrendered for taxes		(1,205)		(1,205)
Stock-based compensation		10,023		10,023
Unrealized gain (loss) on investments and other	[1]	(937)			(937)
Net income (loss)		932					932
Ending balance (in shares) at Mar. 31, 2024			28,528,000
Ending balance at Mar. 31, 2024		799,242	$ 0	$ 1,068,436	$ (299)		$ (268,895)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Foreign currency translation loss		$ 62
[1] Includes foreign currency translation losses of $62 thousand and $35 thousand for the three months ended March 31, 2024 and 2023, respectively.

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows (unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Operating Activities
Net income (loss)	$ 932	$ (45,297)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities
Depreciation	1,427	1,093
Accretion on marketable securities	(802)	(606)
Amortization of operating lease right-of-use assets	182	218
Stock-based compensation expense, net	9,299	10,437
Realized gain on investments	(1,213)	(809)
Other, net	(238)	1
Changes in operating assets and liabilities
Accounts receivable	(4,427)	0
Inventory	(2,238)	0
Prepaid expenses and other current assets	(264)	(126)
Other non-current assets	52	(46)
Lease liability	(199)	(165)
Accounts payable	727	107
Accrued expenses and other current liabilities	(5,162)	(3,463)
Accrued rebates	5,312	0
Accrued litigation settlement	12,500	12,500
Net cash provided by (used in) operating activities	15,888	(26,156)
Investing Activities
Purchases of property and equipment	(1,260)	(5,381)
Purchases of investments	(88,335)	(145,576)
Maturities of investments	63,615	154,520
Net cash (used in) provided by investing activities	(25,980)	3,563
Financing Activities
Proceeds from exercise of stock options, net	15,969	2,223
Net cash provided by financing activities	10,583	1,474
Effect of exchange rate changes on cash and cash equivalents	187	(36)
Net increase (decrease) in cash and cash equivalents	678	(21,155)
Cash and cash equivalents at beginning of period	358,328	161,900
Cash and cash equivalents at end of period	359,006	140,745
Supplemental Disclosures of Non-Cash Investing Activities
Unpaid purchases of property and equipment included in accounts payable and accrued expenses	8,456	11,865
Restricted Stock Units (RSUs)
Financing Activities
Taxes paid related to settlement of restricted stock awards	(4,181)	0
Restricted Stock
Financing Activities
Taxes paid related to settlement of restricted stock awards	$ (1,205)	$ (749)

Organization

Organization	3 Months Ended
	Mar. 31, 2024
Accounting Policies [Abstract]
Organization	Organization Krystal Biotech, Inc. (the “Company,” or “we” or other similar pronouns) commenced operations in April 2016. In March 2017, the Company converted from a California limited liability company to a Delaware C-corporation, and changed its name from Krystal Biotech LLC to Krystal Biotech, Inc. In June 2018, the Company incorporated a wholly-owned subsidiary in Australia for the purpose of undertaking preclinical and clinical studies in Australia. In April 2019, the Company incorporated Jeune Aesthetics, Inc. (“Jeune Aesthetics”), in Delaware, a wholly-owned subsidiary, for the purpose of undertaking preclinical and clinical studies for aesthetic skin conditions. In January 2022, August 2022, December 2022, August 2023, and March 2024 the Company incorporated wholly-owned subsidiaries in Switzerland, Netherlands, France, Germany, and Japan, respectively, for the purpose of establishing initial operations in Europe and Japan for the commercialization of the Company’s product pipeline. We are a fully integrated, commercial-stage biotechnology company focused on the discovery, development, manufacturing and commercialization of genetic medicines to treat diseases with high unmet medical needs. Using our patented gene therapy technology platform that is based on engineered herpes simplex virus-1 (“HSV-1”), we create vectors that efficiently deliver therapeutic transgenes to cells of interest in multiple organ systems. The cell’s own machinery then transcribes and translates the transgene to treat the disease. Our vectors are amenable to formulation for non-invasive or minimally invasive routes of administration at a healthcare professional’s office or in the patient’s home by a healthcare professional. Our innovative technology platform is supported by two in-house, commercial scale Current Good Manufacturing Practice (“CGMP”) manufacturing facilities. Liquidity As of March 31, 2024, the Company had an accumulated deficit of $268.9 million. Our transition to operating profitability is dependent upon the continued successful commercialization of VYJUVEK as well as successful development, approval, and commercialization of our other product candidates. Management intends to fund future operations through its on hand cash and cash equivalents, revenue generated from the sale of VYJUVEK, the sale of equity, and may also seek additional capital through arrangements with strategic partners, debt financings, or other sources. There can be no assurance that additional funding will be available on terms acceptable to the Company, if at all.

Summary of Significant Accounti

Summary of Significant Accounting Policies	3 Months Ended
	Mar. 31, 2024
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	Summary of Significant Accounting Policies Basis of Presentation The accompanying interim condensed consolidated financial statements have been prepared in conformity with generally accepted accounting principles in the United States of America (“GAAP”). In the opinion of management, all adjustments, which consist of all normal recurring adjustments necessary for a fair presentation of the Company’s financial position and results of operations for the interim periods presented, are reflected in the interim condensed consolidated financial statements. All intercompany balances and transactions have been eliminated in consolidation. Certain prior period amounts have been reclassified to conform to the current period presentation. The reclassified amounts have no impact on the Company’s previously reported financial position or results of operations. The results of operations for the interim periods are not necessarily indicative of the results of operations to be expected for the full year. These unaudited interim condensed consolidated financial statements should be read in conjunction with the Company’s audited consolidated financial statements and the notes thereto included in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2023 (“2023 10-K”), as filed with the U.S. Securities and Exchange Commission (“SEC”) on February 26, 2024. Use of Estimates The preparation of condensed consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts in the condensed consolidated financial statements and accompanying notes. Actual results could materially differ from those estimates. Management considers many factors in developing the estimates and assumptions that are used in the preparation of these financial statements. Management must apply significant judgment in this process. In addition, other factors may affect estimates, including expected business and operational changes, sensitivity and volatility associated with the assumptions used in developing estimates, and whether historical trends are expected to be representative of future trends. The estimation process often may yield a range of potentially reasonable estimates of the ultimate future outcomes and management must select an amount that falls within that range of reasonable estimates. If actual results in the future vary from the Company’s estimates, the Company will adjust these estimates in the period these variances become known. Estimates are used in the following areas, among others: variable consideration associated with revenue recognition, stock-based compensation expense, accrued expenses, the fair value of financial instruments and the valuation allowance included in the deferred income tax calculation. Concentration of Credit Risk and Off-Balance Sheet Risk Financial instruments that subject the Company to credit risk primarily consist of cash and cash equivalents, short-term investments, long-term investments, and accounts receivable, net. The Company maintains its cash and cash equivalent balances with high-quality financial institutions and, consequently, the Company believes that such funds are subject to minimal credit risk. The Company is exposed to credit risk in the event of default by the financial institutions to the extent amounts recorded on the condensed consolidated balance sheets are in excess of insured limits. The Company has not experienced any credit losses in such accounts and does not believe it is exposed to any significant credit risk on these funds. The Company’s accounts receivable, net and marketable securities, which primarily consist of U.S. government agency securities and treasuries, corporate bonds and commercial paper, potentially subject the Company to concentrations of credit risk. As of March 31, 2024, the credit profile for the Company’s counterparty was deemed to be in good standing and, as such, an allowance for credit losses was not recorded. The Company had one customer for the three months ended March 31, 2024 and no product revenue for the three months ended March 31, 2023. The Company has no financial instruments with off-balance sheet risk of loss. Summary of Significant Accounting Policies See Note 2 to our consolidated financial statements included in our 2023 10-K. There were no material changes to the Company's significant accounting policies during the three months ended March 31, 2024. Recent Accounting Pronouncements There were no accounting pronouncements issued or adopted during the three months ended March 31, 2024 that are expected to have a material impact on the Company’s condensed consolidated financial statements. In December 2023, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2023-09 “Income Taxes (Topic 740): Improvements to Income Tax Disclosures.” The purpose of this guidance is to enhance the transparency and usefulness of income tax disclosures and provide comprehensive income tax information, particularly in relation to rate reconciliation and income taxes paid in the U.S. and foreign jurisdictions. This new standard will be effective for fiscal years starting after December 15, 2024, with the option to apply it retrospectively. Early adoption is also allowed. Currently, the Company is assessing the potential impact of this guidance on its consolidated financial statement disclosures.

Revenue Recognition

Revenue Recognition	3 Months Ended
	Mar. 31, 2024
Revenue from Contract with Customer [Abstract]
Revenue Recognition	Revenue Recognition Following FDA approval on May 19, 2023, the Company began commercial marketing and sales of VYJUVEK throughout the United States and began recognizing revenue in the third quarter of 2023. The following table summarizes changes in allowances and discounts for the three months ended March 31, 2024: (in thousands) Rebates Prompt Pay Other Accruals Total Balance as of December 31, 2023 $ 5,977 $ 858 $ 279 $ 7,114 Provisions 5,746 1,565 211 7,522 Payments/Credits (434) (953) (75) (1,462) Balance, as of March 31, 2024 $ 11,289 $ 1,470 $ 415 $ 13,174 Rebates and other accruals are included in accrued rebates and accrued expenses and other current liabilities, respectively, on the condensed consolidated balance sheets. Prompt pay is recorded as an allowance against accounts receivable, net on the condensed consolidated balance sheets. Provisions for rebates, prompt pay and other accruals are recorded as a reduction to product revenue on the condensed consolidated statements of operations and comprehensive loss.

Net Income (Loss) Per Share Att

Net Income (Loss) Per Share Attributable to Common Stockholders	3 Months Ended
	Mar. 31, 2024
Earnings Per Share [Abstract]
Net Income (Loss) Per Share Attributable to Common Stockholders	Net Income (Loss) Per Share Attributable to Common Stockholders Basic net income (loss) per share attributable to common stockholders is calculated by dividing net income (loss) attributable to common stockholders by the weighted average shares outstanding during the period, without consideration for common stock equivalents. Diluted net income (loss) per share attributable to common stockholders is computed by dividing the net income (loss) by the weighted-average number of shares of common stock and common stock equivalents outstanding for the period. Common stock equivalents consist of common stock issuable upon (1) exercise of stock options and (2) vesting of restricted stock awards, restricted stock units and performance-based restricted stock units (collectively, “restricted stock”). For the three months ended March 31, 2024 and 2023, respectively, there were (1) 154 thousand and 3.8 million common stock equivalents outstanding in the form of stock options and (2) 78 thousand and 291 thousand unvested restricted stock, that have each been excluded from the calculation of diluted net income (loss) per common share as their effect would be anti-dilutive. Three Months Ended March 31, (in thousands, except per share data) 2024 2023 Numerator: Net income (loss) $ 932 $ (45,297) Denominator: Weighted-average basic common shares 28,295 25,712 Dilutive effect of stock options and unvested restricted stock 996 — Weighted-average diluted common shares 29,291 25,712 Net income (loss) per common share—Basic $ 0.03 $ (1.76) Net income (loss) per common share—Diluted $ 0.03 $ (1.76)

Fair Value Instruments

Fair Value Instruments	3 Months Ended
	Mar. 31, 2024
Fair Value Disclosures [Abstract]
Fair Value Instruments	Fair Value Instruments The following tables show the Company’s cash, cash equivalents and available-for-sale securities by significant investment category as of March 31, 2024 and December 31, 2023: March 31, 2024 (in thousands) Amortized Cost Gross Gross Unrealized (Losses) Aggregate Fair Cash and Cash Short-term Marketable Securities (1) Long-term Marketable Securities (2) Level 1: Cash and cash equivalents $ 359,006 $ — $ — $ 359,006 $ 359,006 $ — $ — Subtotal 359,006 — — 359,006 359,006 — — Level 2: Commercial paper 18,747 — (7) 18,740 — 18,740 — Corporate bonds 115,918 132 (69) 115,981 — 70,182 45,799 U.S. government agency securities 128,682 29 (183) 128,528 — 90,331 38,197 Subtotal 263,347 161 (259) 263,249 — 179,253 83,996 Total $ 622,353 $ 161 $ (259) $ 622,255 $ 359,006 $ 179,253 $ 83,996 December 31, 2023 (in thousands) Amortized Cost Gross Gross Unrealized (Losses) Aggregate Fair Cash and Cash Short-term Marketable Securities (1) Long-term Marketable Securities (2) Level 1: Cash and cash equivalents $ 358,328 $ — $ — $ 358,328 $ 358,328 $ — $ — Subtotal 358,328 — — 358,328 358,328 — — Level 2: Commercial paper 17,124 5 (1) 17,128 — 17,128 — Corporate bonds 111,824 407 (27) 112,204 — 70,996 41,208 U.S. government agency securities 106,079 423 (30) 106,472 — 85,726 20,746 Subtotal 235,027 835 (58) 235,804 — 173,850 61,954 Total $ 593,355 $ 835 $ (58) $ 594,132 $ 358,328 $ 173,850 $ 61,954 (1) The Company’s short-term marketable securities mature in one year or less. (2) The Company’s long-term marketable securities mature between one year and two years.

Balance Sheet Components

Balance Sheet Components	3 Months Ended
	Mar. 31, 2024
Balance Sheet Related Disclosures [Abstract]
Balance Sheet Components	Balance Sheet Components Inventory Inventory consisted of the following: (in thousands) March 31, December 31, Raw materials $ 4,489 $ 3,154 Work-in-process 6,387 3,204 Finished goods 161 627 Inventory $ 11,037 $ 6,985 Property and Equipment, Net Property and equipment, net consisted of the following: (in thousands) March 31, December 31, Building and building improvements $ 111,232 $ 111,180 Leasehold improvements 25,363 25,068 Manufacturing equipment 25,281 24,905 Construction in progress 6,905 7,291 Laboratory equipment 3,064 2,339 Computer equipment and software 1,647 1,614 Furniture and fixtures 1,640 1,632 Total property and equipment 175,132 174,029 Accumulated depreciation (15,121) (12,827) Property and equipment, net $ 160,011 $ 161,202 Depreciation expense was $1.4 million and $1.1 million for the three months ended March 31, 2024 and 2023, respectively. Depreciation expense capitalized into inventory was $867 thousand and zero for the three months ended March 31, 2024 and 2023, respectively. In March 2023, the Company received the permanent occupancy permit for its second commercial scale CGMP facility, ASTRA, which allowed the Company to begin utilizing certain portions of the building. As a result, and as qualification of assets occurred through 2023 and the first quarter of 2024, the majority of assets relating to ASTRA were reclassified from construction in progress to leasehold improvements, manufacturing equipment, buildings and building improvements, furniture and fixtures, or computer equipment and software as it was determined that assets were ready for their intended use. As certain pieces of equipment are not yet qualified, the Company will continue to hold the remaining assets within construction in progress until qualification has been completed and the assets are ready for their intended use. Estimated remaining payments related to ASTRA were $8.0 million as of March 31, 2024 and are recorded in accounts payable and accrued expenses and other current liabilities on the condensed consolidated balance sheets. Accrued Expenses and Other Current Liabilities Accrued expenses and other current liabilities consisted of the following as of March 31, 2024 and December 31, 2023: (in thousands) March 31, December 31, Accrued litigation settlement $ 12,500 $ — Accrued construction-in-progress 4,998 5,182 Accrued payroll and benefits 3,433 8,778 Accrued professional fees 2,654 1,810 Other current liabilities 2,613 2,210 Accrued taxes 2,431 2,283 Accrued preclinical and clinical expenses 882 1,248 Total $ 29,511 $ 21,511

Commitments and Contingencies

Commitments and Contingencies	3 Months Ended
	Mar. 31, 2024
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies Agreements with Contract Manufacturing Organizations and Contract Research Organizations The Company enters into various agreements in the normal course of business with Contract Research Organizations (“CROs”), Contract Manufacturing Organizations (“CMOs”) and other third parties for preclinical research studies, clinical trials and testing and manufacturing services. The agreements with CMOs primarily relate to the manufacturing of our sterile gel that is mixed with in-house produced vectors as part of the final drug product for VYJUVEK. Agreements with third parties may also include research and development consulting activities, clinical-trial agreements, storage, packaging, labeling, and/or testing of our pre-commercial and clinical-stage products. The Company is obligated to make milestone payments under certain of these contracts. The Company may also be responsible for the payment of a monthly service fee for project management services for the duration of any agreements. The estimated remaining commitments as of March 31, 2024 under these agreements is approximately $1.1 million. The Company has incurred research and development expenses under these agreements of $1.5 million for the three months ended March 31, 2024 and $2.0 million for the three months ended March 31, 2023. Legal Proceedings In May 2020, a complaint was filed against the Company in the United States District Court for the Western District of Pennsylvania by PeriphaGen, Inc. (“PeriphaGen”) alleging breach of contract and misappropriation of trade secrets. On April 27, 2022, the Company and PeriphaGen entered into a final settlement agreement, and the Company paid PeriphaGen an upfront payment of $25.0 million on April 28, 2022 for: (i) the release of all claims in the trade secret litigation with PeriphaGen; (ii) the acquisition of certain PeriphaGen assets, and (iii) the grant of a license by PeriphaGen for dermatological applications. In accordance with the settlement agreement, on June 15, 2023, the Company paid PeriphaGen an additional $12.5 million following the FDA’s approval of VYJUVEK. The settlement agreement requires the Company to pay three additional $12.5 million contingent milestone payments upon reaching $100.0 million in total cumulative sales, $200.0 million in total cumulative sales and $300.0 million in total cumulative sales. As defined in the settlement agreement, cumulative sales shall include all revenue from sales of the Company’s products by the Company and its affiliates and licensees, as reported by the Company in its annual Form 10-K filings. If all milestones are achieved, the total consideration for settling the dispute, acquiring certain assets, and granting of a license from PeriphaGen will be $75.0 million, of which $37.5 million has been paid. The Company recorded litigation settlement expense of $12.5 million for each of the three months ended March 31, 2024 and 2023 on the condensed consolidated statements of operations and comprehensive loss in accordance with the settlement agreement. During the three months ended March 31, 2024, in accordance with ASC 450, Contingencies (“ASC 450”), the Company determined that reaching $100.0 million in total cumulative sales was probable, and recorded litigation settlement expense of $12.5 million relating to the milestone payment, which becomes payable following the filing of the Annual Report on Form 10-K that reports the $100.0 million in total cumulative sales. The Company recorded litigation settlement expense of $12.5 million for the three months ended March 31, 2023, as it determined that FDA approval of B-VEC was probable. As of March 31, 2024, the Company has not recorded an accrual for the remaining two contingent milestone payments totaling $25.0 million.

Leases

Leases	3 Months Ended
	Mar. 31, 2024
Leases [Abstract]
Leases	Leases As of March 31, 2024, future minimum commitments under the Company’s operating leases with lease terms in excess of 12 months were as follows: (in thousands) Operating 2024 (remaining nine months) $ 1,157 2025 1,277 2026 1,277 2027 1,300 2028 1,325 Thereafter 9,438 Future minimum operating lease payments 15,774 Less: Interest (7,879) Present value of lease liability $ 7,895 As of March 31, 2024 and December 31, 2023, the Company's weighted-average remaining lease term for operating leases was 12.2 years and 12.3 years, respectively, and the Company’s weighted-average discount rate for operating leases was 9.5% as of March 31, 2024 and December 31, 2023. The components of the Company’s lease expense are as follows: Three Months Ended March 31, (in thousands) 2024 2023 Lease cost: Operating lease expense $ 299 $ 463 Variable lease expense 40 59 Total lease expense $ 339 $ 522

Capitalization

Capitalization	3 Months Ended
	Mar. 31, 2024
Equity [Abstract]
Capitalization	Capitalization ATM Program On December 31, 2020, the Company entered into a sales agreement with Cowen and Company, LLC (“Cowen”) with respect to an at-the-market equity offering program (“2020 ATM Program”), under which the Company issued and sold from time to time through Cowen, acting as agent and/or principal, shares of its common stock, par value $0.00001 per share (“Common Stock”), having an aggregate offering price up to $150.0 million (“Placement Shares”). The issuance and sale of the Placement Shares were made pursuant to the Company’s effective “shelf” registration statement on Form S-3 that was filed with the SEC on May 4, 2020 (“2020 Shelf Registration Statement”). During the three months ended March 31, 2023, no shares of Common Stock were issued pursuant to the 2020 ATM Program. The Company’s 2020 Shelf Registration Statement expired on May 4, 2023, and the Company put in place a new at-the-market equity offering program under substantially the same terms as the 2020 ATM Program (“New ATM Program”). Accordingly, on May 8, 2023, the Company entered into a new sales agreement with Cowen to issue and sell shares of the Company’s Common Stock having an aggregate offering price of up to $150.0 million (“New Placement Shares”) from time to time, under which Cowen will act as the Company’s agent and/or principal. The New Placement Shares will be offered and sold pursuant to the Company’s effective shelf registration statement on Form S-3 filed with the SEC on April 6, 2023, and a prospectus supplement relating to the New Placement Shares that was filed with the SEC on May 8, 2023. During the three months ended March 31, 2024, no shares of Common Stock were issued pursuant to the New ATM Program, resulting in $150.0 million available for issuance under the New ATM Program.

Stock-Based Compensation

Stock-Based Compensation	3 Months Ended
	Mar. 31, 2024
Share-Based Payment Arrangement [Abstract]
Stock-Based Compensation	Stock-Based Compensation In 2017, the Company adopted the 2017 IPO Stock Plan (“Plan”), which governs the issuance of equity awards to employees, certain non-employee consultants, and directors. Initially, the Company reserved 900 thousand shares for issuance under the Plan with an initial sublimit for incentive stock options of 900 thousand shares. On an annual basis, the amount of shares available for issuance under the Plan increases by an amount equal to four percent of the total outstanding shares as of the last day of the preceding calendar year. The sublimit of incentive stock options is not subject to the increase. The Company has historically granted stock options and restricted stock awards (“RSAs”) to its employees. In February 2023, the Company began issuing restricted stock units (“RSUs”) and performance-based restricted stock units (“PSUs” and with RSUs commonly referred to collectively as “restricted stock units”) to certain employees. Shares remaining available for grant under the Plan were 2.4 million as of March 31, 2024. Stock Options The following table summarizes the Company’s stock option activity for the three months ended March 31, 2024: Stock Options Outstanding Weighted-average Exercise Price Weighted-average Remaining Contractual Life (in years) Aggregate Intrinsic Value (1) (in thousands) Outstanding as of December 31, 2023 2,606,592 $ 66.39 7.9 $ 150,405 Granted 126,742 $ 155.82 Exercised (259,581) $ 61.52 Cancelled or forfeited (245,659) $ 67.89 Outstanding as of March 31, 2024 2,228,094 $ 71.88 7.7 $ 236,279 Exercisable as of March 31, 2024 854,224 $ 61.08 6.8 $ 99,815 (1) Aggregate intrinsic value represents the difference between the closing stock price of our common stock on December 31, 2023 and March 31, 2024, respectively, and the exercise price of outstanding in-the-money options. The following table summarizes the Company’s stock option activity for the three months ended March 31, 2023: Stock Options Outstanding Weighted-average Exercise Price Weighted-average Remaining Contractual Life (in years) Aggregate Intrinsic Value (1) (in thousands) Outstanding as of December 31, 2022 3,582,181 $ 61.15 8.7 $ 64,880 Granted 287,600 $ 81.83 Exercised (42,021) $ 53.54 Cancelled or forfeited (42,625) $ 65.59 Outstanding as of March 31, 2023 3,785,135 $ 62.75 8.5 $ 66,066 Exercisable as of March 31, 2023 961,428 $ 55.08 7.6 $ 24,033 (1) Aggregate intrinsic value represents the difference between the closing stock price of our common stock on December 31, 2022 and March 31, 2023, respectively, and the exercise price of outstanding in-the-money options. The total intrinsic value (the amount by which the fair market value exceeds the exercise price) of stock options exercised was $24.5 million and $1.1 million during the three months ended March 31, 2024 and 2023, respectively. The weighted-average grant-date fair value per share of options granted to employees, non-employees, and directors was $106.92 and $56.86 during the three months ended March 31, 2024 and 2023, respectively. There was $63.9 million of unrecognized stock-based compensation expense related to employees’, non-employees’, and directors’ options that is expected to be recognized over a weighted-average period of 2.6 years as of March 31, 2024. Restricted Stock Awards The following table summarizes the Company’s RSA activity: Three Months Ended March 31, 2024 2023 Number of Shares Weighted Average Grant Date Fair Value Number of Shares Weighted Average Grant Date Fair Value Non-vested RSAs, beginning of period 44,400 $ 78.89 66,600 $ 78.89 Granted — — Vested (14,523) $ 78.89 (12,649) $ 78.89 Surrendered for taxes (7,677) $ 78.89 (9,551) $ 78.89 Non-vested RSAs, end of period 22,200 $ 78.89 44,400 $ 78.89 There was $1.6 million of unrecognized stock-based compensation expense related to employees’ RSAs that is expected to be recognized over a weighted-average period of 11 months as of March 31, 2024. Restricted Stock Units The following table summarizes the Company’s RSU activity: Three Months Ended March 31, 2024 2023 Number of Shares Weighted Average Grant Date Fair Value Number of Shares Weighted Average Grant Date Fair Value Non-vested RSUs, beginning of period 160,900 $ 81.91 — Granted 223,890 $ 159.59 186,900 $ 81.91 Vested (40,075) $ 81.91 — Forfeited (14,383) $ 86.27 — Non-vested RSUs, end of period 330,332 $ 134.37 186,900 $ 81.91 There was $43.4 million of unrecognized stock-based compensation expense related to employees’ RSU awards that is expected to be recognized over a weighted-average period of 3.7 years as of March 31, 2024. Performance-Based Restricted Stock Units The following table summarizes the Company’s PSU activity: Three Months Ended March 31, 2024 2023 Number of Shares Weighted Average Grant Date Fair Value Number of Shares Weighted Average Grant Date Fair Value Non-vested PSUs, beginning of period 50,000 $ 81.91 — Granted 112,500 $ 159.47 60,000 $ 81.91 Vested (25,000) $ 81.91 — Forfeited — — Non-vested PSUs, end of period 137,500 $ 145.37 60,000 $ 81.91 For the three months ended March 31, 2024, the Company granted 112,500 of PSUs, which vest ratably over two There was $19.0 million of unrecognized stock-based compensation expense related to employees’ PSU awards that is expected to be recognized over a weighted-average period of 1.8 years as of March 31, 2024. Stock-Based Compensation Expense, Net The Company recorded stock-based compensation expense related to its stock options, RSAs, RSUs, and PSUs in the condensed consolidated statements of operations and comprehensive loss for the three months ended March 31, 2024 and 2023 as follows: Three Months Ended March 31, (in thousands) 2024 2023 Research and development $ 1,868 $ 2,496 Selling, general, and administrative 7,431 7,941 Total stock-based compensation $ 9,299 $ 10,437 After the FDA approval of VYJUVEK on May 19, 2023, the Company began capitalizing stock-based compensation associated with the allocation of labor costs related to work performed to manufacture VYJUVEK. For the three months ended March 31, 2024 and 2023, the Company capitalized stock-based compensation of $724 thousand and zero, respectively, into inventory.

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2024
Income Tax Disclosure [Abstract]
Income Taxes	Income TaxesThe tax provision for interim periods is calculated using an estimate of the annual effective tax rate, adjusted for discrete items. If there are any changes to the estimated annual tax rate, the Company will make a cumulative adjustment to the income tax provision in the period the change becomes known. The Company did not record an income tax provision for the three months ended March 31, 2024 or 2023 as it generated sufficient tax losses, after consideration of discrete items, during each of the periods.

Subsequent Events

Subsequent Events	3 Months Ended
	Mar. 31, 2024
Subsequent Events [Abstract]
Subsequent Events	Subsequent Events The Company evaluates events or transactions that occur after the balance sheet date, but prior to the issuance of the financial statements, to identify matters that require recognition or disclosure. The Company concluded that no subsequent events have occurred, that would require recognition or disclosure in the condensed consolidated financial statements.

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Pay vs Performance Disclosure
Net income (loss)	$ 932	$ (45,297)

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Mar. 31, 2024
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2024
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The accompanying interim condensed consolidated financial statements have been prepared in conformity with generally accepted accounting principles in the United States of America (“GAAP”). In the opinion of management, all adjustments, which consist of all normal recurring adjustments necessary for a fair presentation of the Company’s financial position and results of operations for the interim periods presented, are reflected in the interim condensed consolidated financial statements. All intercompany balances and transactions have been eliminated in consolidation. Certain prior period amounts have been reclassified to conform to the current period presentation. The reclassified amounts have no impact on the Company’s previously reported financial position or results of operations. The results of operations for the interim periods are not necessarily indicative of the results of operations to be expected for the full year. These unaudited interim condensed consolidated financial statements should be read in conjunction with the Company’s audited consolidated financial statements and the notes thereto included in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2023 (“2023 10-K”), as filed with the U.S. Securities and Exchange Commission (“SEC”) on February 26, 2024.
Use of Estimates	Use of Estimates The preparation of condensed consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts in the condensed consolidated financial statements and accompanying notes. Actual results could materially differ from those estimates. Management considers many factors in developing the estimates and assumptions that are used in the preparation of these financial statements. Management must apply significant judgment in this process. In addition, other factors may affect estimates, including expected business and operational changes, sensitivity and volatility associated with the assumptions used in developing estimates, and whether historical trends are expected to be representative of future trends. The estimation process often may yield a range of potentially reasonable estimates of the ultimate future outcomes and management must select an amount that falls within that range of reasonable estimates. If actual results in the future vary from the Company’s estimates, the Company will adjust these estimates in the period these variances become known. Estimates are used in the following areas, among others: variable consideration associated with revenue recognition, stock-based compensation expense, accrued expenses, the fair value of financial instruments and the valuation allowance included in the deferred income tax calculation.
Concentration of Credit Risk and Off-Balance Sheet Risk	Concentration of Credit Risk and Off-Balance Sheet Risk
Off-Balance Sheet Risk	Concentration of Credit Risk and Off-Balance Sheet Risk
Recent Accounting Pronouncements	Recent Accounting Pronouncements There were no accounting pronouncements issued or adopted during the three months ended March 31, 2024 that are expected to have a material impact on the Company’s condensed consolidated financial statements. In December 2023, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2023-09 “Income Taxes (Topic 740): Improvements to Income Tax Disclosures.” The purpose of this guidance is to enhance the transparency and usefulness of income tax disclosures and provide comprehensive income tax information, particularly in relation to rate reconciliation and income taxes paid in the U.S. and foreign jurisdictions. This new standard will be effective for fiscal years starting after December 15, 2024, with the option to apply it retrospectively. Early adoption is also allowed. Currently, the Company is assessing the potential impact of this guidance on its consolidated financial statement disclosures.

Revenue Recognition (Tables)

Revenue Recognition (Tables)	3 Months Ended
	Mar. 31, 2024
Revenue from Contract with Customer [Abstract]
Changes in Allowances and Discounts	The following table summarizes changes in allowances and discounts for the three months ended March 31, 2024: (in thousands) Rebates Prompt Pay Other Accruals Total Balance as of December 31, 2023 $ 5,977 $ 858 $ 279 $ 7,114 Provisions 5,746 1,565 211 7,522 Payments/Credits (434) (953) (75) (1,462) Balance, as of March 31, 2024 $ 11,289 $ 1,470 $ 415 $ 13,174

Net Income (Loss) Per Share A_2

Net Income (Loss) Per Share Attributable to Common Stockholders (Tables)	3 Months Ended
	Mar. 31, 2024
Earnings Per Share [Abstract]
Schedule of Net Income (Loss) Per Share Attributable to Common Stockholders	Three Months Ended March 31, (in thousands, except per share data) 2024 2023 Numerator: Net income (loss) $ 932 $ (45,297) Denominator: Weighted-average basic common shares 28,295 25,712 Dilutive effect of stock options and unvested restricted stock 996 — Weighted-average diluted common shares 29,291 25,712 Net income (loss) per common share—Basic $ 0.03 $ (1.76) Net income (loss) per common share—Diluted $ 0.03 $ (1.76)

Fair Value Instruments (Tables)

Fair Value Instruments (Tables)	3 Months Ended
	Mar. 31, 2024
Fair Value Disclosures [Abstract]
Summary of Cash, Cash Equivalents and Available-for-Sale Securities	The following tables show the Company’s cash, cash equivalents and available-for-sale securities by significant investment category as of March 31, 2024 and December 31, 2023: March 31, 2024 (in thousands) Amortized Cost Gross Gross Unrealized (Losses) Aggregate Fair Cash and Cash Short-term Marketable Securities (1) Long-term Marketable Securities (2) Level 1: Cash and cash equivalents $ 359,006 $ — $ — $ 359,006 $ 359,006 $ — $ — Subtotal 359,006 — — 359,006 359,006 — — Level 2: Commercial paper 18,747 — (7) 18,740 — 18,740 — Corporate bonds 115,918 132 (69) 115,981 — 70,182 45,799 U.S. government agency securities 128,682 29 (183) 128,528 — 90,331 38,197 Subtotal 263,347 161 (259) 263,249 — 179,253 83,996 Total $ 622,353 $ 161 $ (259) $ 622,255 $ 359,006 $ 179,253 $ 83,996 December 31, 2023 (in thousands) Amortized Cost Gross Gross Unrealized (Losses) Aggregate Fair Cash and Cash Short-term Marketable Securities (1) Long-term Marketable Securities (2) Level 1: Cash and cash equivalents $ 358,328 $ — $ — $ 358,328 $ 358,328 $ — $ — Subtotal 358,328 — — 358,328 358,328 — — Level 2: Commercial paper 17,124 5 (1) 17,128 — 17,128 — Corporate bonds 111,824 407 (27) 112,204 — 70,996 41,208 U.S. government agency securities 106,079 423 (30) 106,472 — 85,726 20,746 Subtotal 235,027 835 (58) 235,804 — 173,850 61,954 Total $ 593,355 $ 835 $ (58) $ 594,132 $ 358,328 $ 173,850 $ 61,954 (1) The Company’s short-term marketable securities mature in one year or less. (2) The Company’s long-term marketable securities mature between one year and two years.

Balance Sheet Components (Table

Balance Sheet Components (Tables)	3 Months Ended
	Mar. 31, 2024
Balance Sheet Related Disclosures [Abstract]
Schedule of Inventories	Inventory consisted of the following: (in thousands) March 31, December 31, Raw materials $ 4,489 $ 3,154 Work-in-process 6,387 3,204 Finished goods 161 627 Inventory $ 11,037 $ 6,985
Schedule of Property and Equipment, Net	Property and equipment, net consisted of the following: (in thousands) March 31, December 31, Building and building improvements $ 111,232 $ 111,180 Leasehold improvements 25,363 25,068 Manufacturing equipment 25,281 24,905 Construction in progress 6,905 7,291 Laboratory equipment 3,064 2,339 Computer equipment and software 1,647 1,614 Furniture and fixtures 1,640 1,632 Total property and equipment 175,132 174,029 Accumulated depreciation (15,121) (12,827) Property and equipment, net $ 160,011 $ 161,202
Schedule of Accrued Expenses and Other Current Liabilities	Accrued expenses and other current liabilities consisted of the following as of March 31, 2024 and December 31, 2023: (in thousands) March 31, December 31, Accrued litigation settlement $ 12,500 $ — Accrued construction-in-progress 4,998 5,182 Accrued payroll and benefits 3,433 8,778 Accrued professional fees 2,654 1,810 Other current liabilities 2,613 2,210 Accrued taxes 2,431 2,283 Accrued preclinical and clinical expenses 882 1,248 Total $ 29,511 $ 21,511

Leases (Tables)

Leases (Tables)	3 Months Ended
	Mar. 31, 2024
Leases [Abstract]
Schedule of Future Minimum Operating Lease Payments	As of March 31, 2024, future minimum commitments under the Company’s operating leases with lease terms in excess of 12 months were as follows: (in thousands) Operating 2024 (remaining nine months) $ 1,157 2025 1,277 2026 1,277 2027 1,300 2028 1,325 Thereafter 9,438 Future minimum operating lease payments 15,774 Less: Interest (7,879) Present value of lease liability $ 7,895
Lease, Cost	The components of the Company’s lease expense are as follows: Three Months Ended March 31, (in thousands) 2024 2023 Lease cost: Operating lease expense $ 299 $ 463 Variable lease expense 40 59 Total lease expense $ 339 $ 522

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	3 Months Ended
	Mar. 31, 2024
Share-Based Payment Arrangement [Abstract]
Schedule of Company's Stock Option Activity	The following table summarizes the Company’s stock option activity for the three months ended March 31, 2024: Stock Options Outstanding Weighted-average Exercise Price Weighted-average Remaining Contractual Life (in years) Aggregate Intrinsic Value (1) (in thousands) Outstanding as of December 31, 2023 2,606,592 $ 66.39 7.9 $ 150,405 Granted 126,742 $ 155.82 Exercised (259,581) $ 61.52 Cancelled or forfeited (245,659) $ 67.89 Outstanding as of March 31, 2024 2,228,094 $ 71.88 7.7 $ 236,279 Exercisable as of March 31, 2024 854,224 $ 61.08 6.8 $ 99,815 (1) Aggregate intrinsic value represents the difference between the closing stock price of our common stock on December 31, 2023 and March 31, 2024, respectively, and the exercise price of outstanding in-the-money options. The following table summarizes the Company’s stock option activity for the three months ended March 31, 2023: Stock Options Outstanding Weighted-average Exercise Price Weighted-average Remaining Contractual Life (in years) Aggregate Intrinsic Value (1) (in thousands) Outstanding as of December 31, 2022 3,582,181 $ 61.15 8.7 $ 64,880 Granted 287,600 $ 81.83 Exercised (42,021) $ 53.54 Cancelled or forfeited (42,625) $ 65.59 Outstanding as of March 31, 2023 3,785,135 $ 62.75 8.5 $ 66,066 Exercisable as of March 31, 2023 961,428 $ 55.08 7.6 $ 24,033 (1) Aggregate intrinsic value represents the difference between the closing stock price of our common stock on December 31, 2022 and March 31, 2023, respectively, and the exercise price of outstanding in-the-money options.
Share-based Payment Arrangement, Restricted Stock and Restricted Stock Unit, Activity	The following table summarizes the Company’s RSA activity: Three Months Ended March 31, 2024 2023 Number of Shares Weighted Average Grant Date Fair Value Number of Shares Weighted Average Grant Date Fair Value Non-vested RSAs, beginning of period 44,400 $ 78.89 66,600 $ 78.89 Granted — — Vested (14,523) $ 78.89 (12,649) $ 78.89 Surrendered for taxes (7,677) $ 78.89 (9,551) $ 78.89 Non-vested RSAs, end of period 22,200 $ 78.89 44,400 $ 78.89 The following table summarizes the Company’s RSU activity: Three Months Ended March 31, 2024 2023 Number of Shares Weighted Average Grant Date Fair Value Number of Shares Weighted Average Grant Date Fair Value Non-vested RSUs, beginning of period 160,900 $ 81.91 — Granted 223,890 $ 159.59 186,900 $ 81.91 Vested (40,075) $ 81.91 — Forfeited (14,383) $ 86.27 — Non-vested RSUs, end of period 330,332 $ 134.37 186,900 $ 81.91
Share-Based Payment Arrangement, Performance Shares, Activity	The following table summarizes the Company’s PSU activity: Three Months Ended March 31, 2024 2023 Number of Shares Weighted Average Grant Date Fair Value Number of Shares Weighted Average Grant Date Fair Value Non-vested PSUs, beginning of period 50,000 $ 81.91 — Granted 112,500 $ 159.47 60,000 $ 81.91 Vested (25,000) $ 81.91 — Forfeited — — Non-vested PSUs, end of period 137,500 $ 145.37 60,000 $ 81.91
Summary of Stock Based Compensation Expense Related to Issuance of Stock Option Awards and Restricted Stock Awards	The Company recorded stock-based compensation expense related to its stock options, RSAs, RSUs, and PSUs in the condensed consolidated statements of operations and comprehensive loss for the three months ended March 31, 2024 and 2023 as follows: Three Months Ended March 31, (in thousands) 2024 2023 Research and development $ 1,868 $ 2,496 Selling, general, and administrative 7,431 7,941 Total stock-based compensation $ 9,299 $ 10,437

Organization - Additional Infor

Organization - Additional Information (Detail) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Accounting Policies [Abstract]
Accumulated deficit	$ 268,895	$ 269,827
Cash, cash equivalents and short-term investments	$ 538,300

Revenue Recognition - Allowance

Revenue Recognition - Allowances And Discounts (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2024 USD ($)
Accounts Receivable, Allowance For Credit Loss [Roll Forward]
Balance as of December 31, 2023	$ 7,114
Provisions	7,522
Payments/Credits	(1,462)
Balance, as of March 31, 2024	13,174
Rebates
Accounts Receivable, Allowance For Credit Loss [Roll Forward]
Balance as of December 31, 2023	5,977
Provisions	5,746
Payments/Credits	(434)
Balance, as of March 31, 2024	11,289
Prompt Pay
Accounts Receivable, Allowance For Credit Loss [Roll Forward]
Balance as of December 31, 2023	858
Provisions	1,565
Payments/Credits	(953)
Balance, as of March 31, 2024	1,470
Other Accruals
Accounts Receivable, Allowance For Credit Loss [Roll Forward]
Balance as of December 31, 2023	279
Provisions	211
Payments/Credits	(75)
Balance, as of March 31, 2024	$ 415

Net Income (Loss) Per Share A_3

Net Income (Loss) Per Share Attributable to Common Stockholders - Additional Information (Detail) - shares shares in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Stock Options and Unvested Restricted Stocks Awards
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Common share equivalents outstanding, excluded from the calculation of diluted net loss per common share	154	3,800
Restricted Stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Common share equivalents outstanding, excluded from the calculation of diluted net loss per common share	78	291

Net Income (Loss) Per Share A_4

Net Income (Loss) Per Share Attributable to Common Stockholders - Schedule of Basic and Diluted Net Loss Per Share and Per Unit (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Numerator:
Net income (loss)	$ 932	$ (45,297)
Denominator:
Weighted-average common shares outstanding: basic (in shares)	28,295,000	25,712,000
Dilutive effect of stock options and unvested restricted stock (in shares)	996,000	0
Weighted-average common shares outstanding: diluted (in shares)	29,291,000	25,712,000
Net income (loss) per common share: basic (in dollars per share)	$ 0.03	$ (1.76)
Net income (loss) per common share: diluted (in dollars per share)	$ 0.03	$ (1.76)

Fair Value Instruments - Summar

Fair Value Instruments - Summary of Cash, Cash Equivalents and Available-for-Sale Securities (Detail) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Cash and cash equivalents	$ 359,006	$ 358,328
Gross Unrealized Gains	161	835
Gross Unrealized (Losses)	(259)	(58)
Amortized Cost	622,353	593,355
Aggregate fair value, total	622,255	594,132
Cash and Cash Equivalents
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Aggregate fair value, total	359,006	358,328
Short-term Marketable Securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Aggregate fair value, total	179,253	173,850
Long-term Marketable Securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Aggregate fair value, total	83,996	61,954
Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Cash and cash equivalents	359,006	358,328
Aggregate Fair Value	359,006	358,328
Level 1 | Cash and Cash Equivalents
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Cash and cash equivalents	359,006	358,328
Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Amortized Cost	263,347	235,027
Gross Unrealized Gains	161	835
Gross Unrealized (Losses)	(259)	(58)
Aggregate Fair Value	263,249	235,804
Level 2 | Commercial paper
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Amortized Cost	18,747	17,124
Gross Unrealized Gains	0	5
Gross Unrealized (Losses)	(7)	(1)
Aggregate Fair Value	18,740	17,128
Level 2 | Corporate bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Amortized Cost	115,918	111,824
Gross Unrealized Gains	132	407
Gross Unrealized (Losses)	(69)	(27)
Aggregate Fair Value	115,981	112,204
Level 2 | U.S. government agency securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Amortized Cost	128,682	106,079
Gross Unrealized Gains	29	423
Gross Unrealized (Losses)	(183)	(30)
Aggregate Fair Value	128,528	106,472
Level 2 | Short-term Marketable Securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Aggregate Fair Value	$ 179,253	173,850
Debt securities, available-for-sale, term	1 year
Level 2 | Short-term Marketable Securities | Commercial paper
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Aggregate Fair Value	$ 18,740	17,128
Level 2 | Short-term Marketable Securities | Corporate bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Aggregate Fair Value	70,182	70,996
Level 2 | Short-term Marketable Securities | U.S. government agency securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Aggregate Fair Value	90,331	85,726
Level 2 | Long-term Marketable Securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Aggregate Fair Value	83,996	61,954
Level 2 | Long-term Marketable Securities | Commercial paper
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Aggregate Fair Value	0	0
Level 2 | Long-term Marketable Securities | Corporate bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Aggregate Fair Value	45,799	41,208
Level 2 | Long-term Marketable Securities | U.S. government agency securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Aggregate Fair Value	$ 38,197	20,746
Level 2 | Long-term Marketable Securities | Minimum
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale, term	1 year
Level 2 | Long-term Marketable Securities | Maximum
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale, term	2 years
Cash and cash equivalents | Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Cash and cash equivalents	$ 359,006	358,328
Aggregate Fair Value	359,006	358,328
Cash and cash equivalents | Level 1 | Cash and Cash Equivalents
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Cash and cash equivalents	$ 359,006	$ 358,328

Balance Sheet Components - Sche

Balance Sheet Components - Schedule of Inventory (Detail) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Balance Sheet Related Disclosures [Abstract]
Raw materials	$ 4,489	$ 3,154
Work-in-process	6,387	3,204
Finished goods	161	627
Inventory, Net, Total	$ 11,037	$ 6,985

Balance Sheet Components - Sc_2

Balance Sheet Components - Schedule of Property and Equipment, Net (Detail) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Property, Plant and Equipment [Line Items]
Total property and equipment	$ 175,132	$ 174,029
Accumulated depreciation	(15,121)	(12,827)
Property and equipment, net	160,011	161,202
Building and building improvements
Property, Plant and Equipment [Line Items]
Total property and equipment	111,232	111,180
Leasehold improvements
Property, Plant and Equipment [Line Items]
Total property and equipment	25,363	25,068
Manufacturing equipment
Property, Plant and Equipment [Line Items]
Total property and equipment	25,281	24,905
Construction in progress
Property, Plant and Equipment [Line Items]
Total property and equipment	6,905	7,291
Laboratory equipment
Property, Plant and Equipment [Line Items]
Total property and equipment	3,064	2,339
Computer equipment and software
Property, Plant and Equipment [Line Items]
Total property and equipment	1,647	1,614
Furniture and fixtures
Property, Plant and Equipment [Line Items]
Total property and equipment	$ 1,640	$ 1,632

Balance Sheet Components - Addi

Balance Sheet Components - Additional Information (Detail) - USD ($)	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Supply Commitment [Line Items]
Depreciation expense	$ 1,427,000	$ 1,093,000
Depreciation expense capitalized	867,000	$ 0
ASTRA Facility
Supply Commitment [Line Items]
Contractual obligation	$ 8,000,000

Balance Sheet Components - Sc_3

Balance Sheet Components - Schedule of Accrued Expenses And Other Current Liabilities (Detail) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Balance Sheet Related Disclosures [Abstract]
Accrued litigation settlement	$ 12,500	$ 0
Accrued construction-in-progress	4,998	5,182
Accrued payroll and benefits	3,433	8,778
Accrued professional fees	2,654	1,810
Other current liabilities	2,613	2,210
Accrued taxes	2,431	2,283
Accrued preclinical and clinical expenses	882	1,248
Total	$ 29,511	$ 21,511

Commitments and Contingencies (

Commitments and Contingencies (Detail) $ in Thousands				3 Months Ended		10 Months Ended
	Jun. 15, 2023 USD ($)	Apr. 28, 2022 USD ($)	Apr. 27, 2022 USD ($) milestone	Mar. 31, 2024 USD ($)	Mar. 31, 2023 USD ($)	Mar. 31, 2024 USD ($)
Operating Leased Assets [Line Items]
Litigation settlement				$ 12,500	$ 12,500
PeriphaGen
Operating Leased Assets [Line Items]
Litigation settlement	$ 12,500	$ 25,000		12,500	12,500	$ 37,500
Number of milestones | milestone			3
Litigation settlement, total consideration	$ 75,000
PeriphaGen | Milestone Three
Operating Leased Assets [Line Items]
Litigation settlement, amount awarded to other party			$ 12,500
Litigation settlement, milestone payments, sales threshold			300,000
PeriphaGen | Milestone One
Operating Leased Assets [Line Items]
Litigation settlement, amount awarded to other party			12,500	25,000
Litigation settlement, milestone payments, sales threshold			100,000	100,000
PeriphaGen | Milestone Two
Operating Leased Assets [Line Items]
Litigation settlement, amount awarded to other party			12,500	25,000
Litigation settlement, milestone payments, sales threshold			$ 200,000
PeriphaGen | Remaining Milestones
Operating Leased Assets [Line Items]
Number of milestones | milestone			2
Clinical Supply Agreements
Operating Leased Assets [Line Items]
Estimated remaining commitment				1,100		$ 1,100
Project management service fee				$ 1,500	$ 2,000

Leases - Minimum Commitments (D

Leases - Minimum Commitments (Details) $ in Thousands	Mar. 31, 2024 USD ($)
Leases [Abstract]
2024 (remaining nine months)	$ 1,157
2025	1,277
2026	1,277
2027	1,300
2028	1,325
Thereafter	9,438
Future minimum operating lease payments	15,774
Less: Interest	(7,879)
Present value of lease liability	$ 7,895

Leases - Additional Information

Leases - Additional Information (Details)	Mar. 31, 2024	Dec. 31, 2023
Leases [Abstract]
Weighted average remaining lease term	12 years 2 months 12 days	12 years 3 months 18 days
Weighted average discount rate	9.50%	9.50%

Leases - Lease Expense (Details

Leases - Lease Expense (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Leases [Abstract]
Operating lease expense	$ 299	$ 463
Variable lease expense	40	59
Total lease expense	$ 339	$ 522

Capitalization - Additional Inf

Capitalization - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Millions	Mar. 31, 2024	Dec. 31, 2023	May 08, 2023	Dec. 31, 2020
Schedule of Capitalization, Equity [Line Items]
Common stock, par value (in dollars per share)	$ 0.00001	$ 0.00001		$ 0.00001
Shares issued (in shares)	28,528,000	28,237,000
Placement Shares
Schedule of Capitalization, Equity [Line Items]
Sale of stock, aggregate offering price	$ 150			$ 150
2020 ATM Program
Schedule of Capitalization, Equity [Line Items]
Shares issued (in shares)	0
New ATM Program
Schedule of Capitalization, Equity [Line Items]
Sale of stock, aggregate offering price			$ 150

Stock-Based Compensation - Addi

Stock-Based Compensation - Additional Information (Detail)	3 Months Ended
	Mar. 31, 2024 USD ($) $ / shares shares	Mar. 31, 2023 USD ($) $ / shares shares	Dec. 31, 2017 shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Period increase in shares authorized	0.04
Stock options granted (in shares) | shares	126,742	287,600
Exercised | $	$ 24,500,000	$ 1,100,000
Inventories
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Amount capitalized | $	724,000	0
Property, Plant and Equipment
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Amount capitalized | $	$ 0	$ 162,000
Stock Incentive Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares remaining available for grant | shares	2,400,000
2017 IPO Stock Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares reserved (in shares) | shares			900,000
Stock Options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Weighted-average grant-date fair value per share of options granted (in dollars per share) | $ / shares	$ 106.92	$ 56.86
Stock Options | Director
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized stock-based compensation expense | $	$ 63,900,000
Estimated weighted average period	2 years 7 months 6 days
Stock Options | 2017 IPO Stock Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares reserved (in shares) | shares			900,000
Restricted Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized stock-based compensation expense | $	$ 1,600,000
Estimated weighted average period	11 months
Granted (in shares) | shares	0	0
Restricted Stock Units (RSUs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized stock-based compensation expense | $	$ 43,400,000
Estimated weighted average period	3 years 8 months 12 days
Granted (in shares) | shares	223,890	186,900
Performance Shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized stock-based compensation expense | $	$ 19,000,000
Estimated weighted average period	1 year 9 months 18 days
Granted (in shares) | shares	112,500	60,000
Stock option vesting period	2 years
Eligible to vest	1

Stock-Based Compensation - Sche

Stock-Based Compensation - Schedule of Company's Stock Option Activity (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2023	Dec. 31, 2022
Stock Options Outstanding
Beginning balance (in shares)	2,606,592	3,582,181	3,582,181
Granted (in shares)	126,742	287,600
Exercised (in shares)	(259,581)	(42,021)
Cancelled or forfeited (in shares)	(245,659)	(42,625)
Ending balance (in shares)	2,228,094	3,785,135	2,606,592	3,582,181
Exercisable end of period (in shares)	854,224	961,428
Weighted-average Exercise Price
Beginning balance (in dollars per share)	$ 66.39	$ 61.15	$ 61.15
Granted (in dollars per share)	155.82	81.83
Exercised (in dollars per share)	61.52	53.54
Cancelled or forfeited (in dollars per share)	67.89	65.59
Ending balance (in dollars per share)	71.88	62.75	$ 66.39	$ 61.15
Exercisable end of period (in dollars per share)	$ 61.08	$ 55.08
Weighted-average Remaining Contractual Life (in years)
Weighted-average remaining contractual life (Years)	7 years 8 months 12 days	8 years 6 months	7 years 10 months 24 days	8 years 8 months 12 days
Weighted-average remaining contractual life (Years), exercisable	6 years 9 months 18 days	7 years 7 months 6 days
Aggregate Intrinsic Value
Aggregate intrinsic value, beginning balance, outstanding	$ 150,405	$ 64,880	$ 64,880
Aggregate intrinsic value, ending balance, outstanding	236,279	66,066	$ 150,405	$ 64,880
Exercisable as of March 31, 2024	$ 99,815	$ 24,033

Stock-Based Compensation - Summ

Stock-Based Compensation - Summary of Stock Based Compensation Expense Related to Issuance of Stock Option Awards and Restricted Stock Awards (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Performance Shares
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total stock-based compensation	$ 9,299	$ 10,437
Research and development | Stock Options
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total stock-based compensation	1,868	2,496
Selling, general, and administrative | Stock Options
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total stock-based compensation	$ 7,431	$ 7,941

Stock-Based Compensation - Sc_2

Stock-Based Compensation - Schedule of Company's Stock Activity (Details) - $ / shares	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Restricted Stock
Number of Shares
Beginning balance (in shares)	44,400	66,600
Granted (in shares)	0	0
Vested (in shares)	(14,523)	(12,649)
Surrendered for taxes (in shares)	(7,677)	(9,551)
Ending balance (in shares)	22,200	44,400
Weighted Average Grant Date Fair Value
Beginning balance (in dollars per share)	$ 78.89	$ 78.89
Granted (in dollars per share)
Surrendered for taxes (in dollars per share)	78.89	78.89
Ending balance (in dollars per share)	$ 78.89	$ 78.89
Restricted Stock Units (RSUs)
Number of Shares
Beginning balance (in shares)	160,900	0
Granted (in shares)	223,890	186,900
Vested (in shares)	(40,075)	0
Surrendered for taxes (in shares)	(14,383)	0
Ending balance (in shares)	330,332	186,900
Weighted Average Grant Date Fair Value
Beginning balance (in dollars per share)	$ 81.91
Granted (in dollars per share)	159.59	81.91
Vested (in dollars per share)	81.91
Surrendered for taxes (in dollars per share)	86.27
Ending balance (in dollars per share)	$ 134.37	$ 81.91
Performance Shares
Number of Shares
Beginning balance (in shares)	50,000	0
Granted (in shares)	112,500	60,000
Vested (in shares)	(25,000)	0
Surrendered for taxes (in shares)	0	0
Ending balance (in shares)	137,500	60,000
Weighted Average Grant Date Fair Value
Beginning balance (in dollars per share)	$ 81.91
Granted (in dollars per share)	159.47	81.91
Vested (in dollars per share)	81.91
Surrendered for taxes (in dollars per share)
Ending balance (in dollars per share)	$ 145.37	$ 81.91