10-Q 1 pen-20240331.htm 10-Q pen-20240331
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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 10-Q
(Mark One)
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended March 31, 2024
OR 
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from_____ to _____         
Commission File Number: 001-37557
Penumbra, Inc.
(Exact name of registrant as specified in its charter)
Delaware05-0605598
(State or other jurisdiction of
incorporation or organization)
(I.R.S. Employer
Identification No.)

One Penumbra Place
Alameda, CA 94502
(Address of principal executive offices, including zip code)

(510) 748-3200
(Registrant’s telephone number, including area code)
Securities registered pursuant to Section 12(b) of the Act:
Title of each classTrading SymbolName of each exchange on which registered
Common Stock, Par value $0.001 per sharePENThe New York Stock Exchange
Indicate by check mark whether the registrant: (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.    Yes: ☒    No:  ☐
Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).    Yes:  ☒    No:  ☐
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer a smaller reporting company or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company” and “emerging growth company” in Rule 12b-2 of the Exchange Act.
Large accelerated filerAccelerated filer
Non-accelerated filerSmaller reporting company
Emerging growth company
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with accounting standards provided pursuant to Section 13(a) of the Exchange Act.
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).    Yes:    No:  ☒
As of April 23, 2024, the registrant had 38,764,917 shares of common stock, par value $0.001 per share, outstanding.




FORM 10-Q
TABLE OF CONTENTS
 
Page



PART I - FINANCIAL INFORMATION
ITEM 1. CONDENSED CONSOLIDATED FINANCIAL STATEMENTS.
Penumbra, Inc.
Condensed Consolidated Balance Sheets
(unaudited)
(in thousands)
March 31, 2024December 31, 2023
Assets
Current assets:
Cash and cash equivalents$223,114 $167,486 
Marketable investments90,360 121,701 
Accounts receivable, net of allowance for credit losses of $3,020 and $3,169 at March 31, 2024 and December 31, 2023, respectively
191,989 201,768 
Inventories398,366 388,023 
Prepaid expenses and other current assets31,194 36,424 
Total current assets935,023 915,402 
Property and equipment, net75,744 72,691 
Operating lease right-of-use assets185,845 188,756 
Finance lease right-of-use assets30,234 31,092 
Intangible assets, net68,421 71,056 
Goodwill166,103 166,270 
Deferred taxes84,661 85,158 
Other non-current assets33,814 25,880 
Total assets$1,579,845 $1,556,305 
Liabilities and Stockholders’ Equity
Current liabilities:
Accounts payable$32,454 $27,155 
Accrued liabilities106,549 110,555 
Current operating lease liabilities11,520 11,203 
Current finance lease liabilities2,280 2,231 
Total current liabilities152,803 151,144 
Non-current operating lease liabilities194,537 197,229 
Non-current finance lease liabilities23,098 23,680 
Other non-current liabilities5,876 5,308 
Total liabilities376,314 377,361 
Commitments and contingencies (Note 8)
Stockholders’ equity:
Common stock39 39 
Additional paid-in capital1,062,470 1,047,198 
Accumulated other comprehensive loss (4,838)(3,151)
Retained earnings145,860 134,858 
Total stockholders’ equity1,203,531 1,178,944 
Total liabilities and stockholders’ equity$1,579,845 $1,556,305 

See accompanying notes to the unaudited condensed consolidated financial statements
2

Penumbra, Inc.
Condensed Consolidated Statements of Operations
(unaudited)
(in thousands, except share and per share amounts)
Three Months Ended March 31,
20242023
Revenue$278,655 $241,398 
Cost of revenue97,516 90,326 
Gross profit181,139 151,072 
Operating expenses:
Research and development 24,626 19,986 
Sales, general and administrative 144,412 123,078 
Total operating expenses 169,038 143,064 
Income from operations12,101 8,008 
Interest and other income, net2,525 644 
Income before income taxes14,626 8,652 
Provision for income taxes3,624 90 
Net income$11,002 $8,562 
Net income per share:
Basic$0.28 $0.22 
Diluted$0.28 $0.22 
Weighted average shares outstanding:
Basic38,717,334 38,186,342 
Diluted39,387,359 39,075,388 

See accompanying notes to the unaudited condensed consolidated financial statements
3

Penumbra, Inc.
Condensed Consolidated Statements of Comprehensive Income (Loss)
(unaudited)
(in thousands)
Three Months Ended March 31,
20242023
Net income$11,002 $8,562 
Other comprehensive (loss) income, net of tax:
Foreign currency translation adjustments, net of tax(1,853)403 
Net change in unrealized gains or losses on available-for-sale securities, net of tax166 860 
Total other comprehensive (loss) income, net of tax(1,687)1,263 
Comprehensive income$9,315 $9,825 

See accompanying notes to the unaudited condensed consolidated financial statements

4

Penumbra, Inc.
Condensed Consolidated Statements of Stockholders’ Equity
(unaudited)
(in thousands, except share amounts)
Common StockAdditional Paid-in CapitalAccumulated Other Comprehensive LossRetained Earnings Total Stockholders’ Equity
SharesAmount
Balance at December 31, 202338,681,549 $39 $1,047,198 $(3,151)$134,858 $1,178,944 
Issuance of common stock76,597 — 238 — — 238 
Shares held for tax withholdings(1,732)— (421)— — (421)
Stock-based compensation— — 15,455 — — 15,455 
Other comprehensive loss— — — (1,687)— (1,687)
Net income — — — — 11,002 11,002 
Balance at March 31, 202438,756,414 $39 $1,062,470 $(4,838)$145,860 $1,203,531 


Common StockAdditional Paid-in CapitalAccumulated Other Comprehensive LossRetained Earnings Total Stockholders’ Equity
SharesAmount
Balance at December 31, 202238,107,977 $38 $963,040 $(8,124)$43,904 $998,858 
Issuance of common stock134,936 — 2,209 — — 2,209 
Shares held for tax withholdings(813)— (204)— — (204)
Stock-based compensation— — 13,781 — — 13,781 
Other comprehensive income— — — 1,263 — 1,263 
Net income— — — — 8,562 8,562 
Balance at March 31, 202338,242,100 $38 $978,826 $(6,861)$52,466 $1,024,469 
See accompanying notes to the unaudited condensed consolidated financial statements
5

Penumbra, Inc.
Condensed Consolidated Statements of Cash Flows
(unaudited)
(in thousands)
 Three Months Ended March 31,
 20242023
CASH FLOWS FROM OPERATING ACTIVITIES:
Net income$11,002 $8,562 
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization7,519 6,575 
Stock-based compensation13,569 12,766 
Inventory write-downs358 1,009 
Deferred taxes475 (953)
Other(221)140 
Changes in operating assets and liabilities:
Accounts receivable8,460 (3,540)
Inventories(11,619)(10,641)
Prepaid expenses and other current and non-current assets4,565 (3,994)
Accounts payable5,209 2,074 
Accrued expenses and other non-current liabilities(1,022)1,131 
Net cash provided by operating activities38,295 13,129 
CASH FLOWS FROM INVESTING ACTIVITIES:
Purchases of non-marketable investments(10,000) 
Purchases of marketable investments(11,267) 
Proceeds from maturities of marketable investments43,375 14,605 
Purchases of property and equipment(5,824)(3,894)
Other2,100  
Net cash provided by investing activities18,384 10,711 
CASH FLOWS FROM FINANCING ACTIVITIES:
Proceeds from exercises of stock options238 2,209 
Payment of employee taxes related to vested stock(421)(204)
Payments of finance lease obligations(550)(474)
Other(61)(155)
 Net cash (used in) provided by financing activities(794)1,376 
Effect of foreign exchange rate changes on cash and cash equivalents(257)(386)
NET INCREASE IN CASH AND CASH EQUIVALENTS55,628 24,830 
CASH AND CASH EQUIVALENTS—Beginning of period167,486 69,858 
CASH AND CASH EQUIVALENTS—End of period$223,114 $94,688 
NONCASH INVESTING AND FINANCING ACTIVITIES:
Right-of-use assets obtained in exchange for operating lease obligations$292 $341 
Right-of-use assets obtained in exchange for finance lease obligations$17 $68 
Purchase of property and equipment funded through accounts payable and accrued liabilities$1,816 $1,781 
SUPPLEMENTAL CASH FLOW INFORMATION:
Cash paid for amounts included in the measurement of operating lease liabilities$5,337 $4,706 
Cash paid for income taxes$1,125 $1,413 
See accompanying notes to the unaudited condensed consolidated financial statements
6

Penumbra, Inc.
Notes to Condensed Consolidated Financial Statements
(unaudited)

1. Organization and Description of Business
Penumbra, Inc. (the “Company”) is a global healthcare company focused on innovative therapies. The Company designs, develops, manufactures and markets novel products and has a broad portfolio that addresses challenging medical conditions in markets with significant unmet need. The Company focuses on developing, manufacturing and marketing novel products for use by specialist physicians and other healthcare providers to drive improved clinical and health outcomes. The Company believes that the cost-effectiveness of our products is attractive to our customers.
2. Summary of Significant Accounting Policies
Basis of Presentation and Consolidation
The accompanying condensed consolidated balance sheet as of March 31, 2024, the condensed consolidated statements of operations, the condensed consolidated statements of comprehensive income (loss), and the condensed consolidated statements of stockholders’ equity for the three months ended March 31, 2024 and 2023, and the condensed consolidated statements of cash flows for the three months ended March 31, 2024 and 2023 are unaudited. The unaudited condensed consolidated financial statements included herein have been prepared by the Company in accordance with accounting principles generally accepted in the United States of America (“U.S. GAAP”) and the applicable rules and regulations of the U.S. Securities and Exchange Commission (the “SEC”) for interim financial information. Accordingly, they do not include all of the information and notes required by U.S. GAAP for complete financial statements. The condensed consolidated balance sheet data as of December 31, 2023 was derived from the audited financial statements as of that date.
The unaudited condensed consolidated financial statements have been prepared on the same basis as the audited consolidated financial statements and, in the opinion of management, reflect all adjustments of a normal recurring nature considered necessary to state fairly the Company’s financial position as of March 31, 2024, the results of its operations for the three months ended March 31, 2024 and 2023, the changes in its comprehensive income (loss) and stockholders’ equity for the three months ended March 31, 2024 and 2023, and its cash flows for the three months ended March 31, 2024 and 2023. The results for the three months ended March 31, 2024 are not necessarily indicative of the results that may be expected for the year ending December 31, 2024 or for any other future annual or interim period. Certain changes in presentation were made to interest income (expense), net and other income (expense), net in the condensed consolidated statements of operations for the three months ended March 31, 2023 to conform to the presentation for the three months ended March 31, 2024.
The information included in this Quarterly Report on Form 10-Q should be read in conjunction with the audited consolidated financial statements and notes thereto for the fiscal year ended December 31, 2023, included in the Company’s Annual Report on Form 10-K as filed with the SEC on February 22, 2024. There have been no changes to the Company’s significant accounting policies during the three months ended March 31, 2024, as compared to the significant accounting policies described in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2023.
The condensed consolidated financial statements include the accounts of the Company and its wholly-owned subsidiaries. All intercompany balances and transactions have been eliminated in consolidation.
Use of Estimates
The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities and equity accounts; disclosure of contingent assets and liabilities at the date of the financial statements; and the reported amounts of revenues and expenses during the reporting period. On an ongoing basis, the Company evaluates its estimates, including those related to marketable investments, allowances for credit losses, the amount of variable consideration included in the transaction price, warranty reserve, valuation of inventories, useful lives of property and equipment, intangibles, operating and financing lease right-of-use (“ROU”) assets and liabilities, income taxes, and other contingencies, including the probability of achieving performance targets associated with equity awards with performance conditions, among others. The Company bases its estimates on historical experience and on various other assumptions that are believed to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities that are not readily apparent from other data. Actual results could differ from those estimates.
Segments
7

Penumbra, Inc.
Notes to Condensed Consolidated Financial Statements
(unaudited)
The Company determined its operating segment on the same basis that it uses to evaluate its performance internally. The Company has one business activity: the design, development, manufacturing and marketing of innovative medical products, and operates as one operating segment. The Company’s chief operating decision-maker, its Chief Executive Officer, reviews its consolidated operating results for the purpose of allocating resources and evaluating financial performance.
Recently Issued Accounting Standards
In December 2023, the FASB issued Accounting Standards Update (“ASU”) No. 2023-09, Income Taxes— Improvements to Income Tax Disclosures. The standard enhances annual income tax disclosures, by requiring additional disaggregated information about an entity’s effective tax rate reconciliation and income taxes paid. The ASU adds guidance that requires public business entities to disclose additional information in specified categories with respect to the reconciliation of the effective tax rate to the statutory rate (the rate reconciliation) for federal, state, and foreign income taxes. It also requires greater detail about individual reconciling items in the rate reconciliation to the extent the impact of those items exceeds a specified threshold (5%). In addition to new disclosures associated with the rate reconciliation, the ASU requires information pertaining to taxes paid (net of refunds received) to be disaggregated for federal, state, and foreign taxes and further disaggregated for specific jurisdictions to the extent the related amounts exceed the quantitative threshold. For public business entities, the amendments in ASU 2023-09 are effective for annual periods beginning after December 15, 2024. Early adoption is permitted for annual financial statements not yet issued or made available for issuance. The Company is assessing the impact the new guidance will have on the disclosures within its consolidated financial statements and does not elect to early adopt as of March 31, 2024.
In November 2023, the FASB issued ASU 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures. The ASU expands public entities’ segment disclosures by requiring disclosure of significant segment expenses that are regularly reviewed by the CODM and included within each reported measure of segment profit or loss, an amount and description of its composition for other segment items, and interim disclosures of a reportable segment’s profit or loss and assets. The ASU also allows, in addition to the measure that is most consistent with U.S. GAAP, the disclosure of additional measures of segment profit or loss that are used by the CODM in assessing segment performance and deciding how to allocate resources. All disclosure requirements under ASU 2023-07 are also required for public entities with a single reportable segment. The ASU is effective for fiscal years beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024, on a retrospective basis, with early adoption permitted. The Company is assessing the impact the new guidance will have on the disclosures within its consolidated financial statements and does not elect to early adopt as of March 31, 2024.
In March 2024, the SEC issued Release Nos. 33-11275; 34-99678 "The Enhancement and Standardization of Climate-Related Disclosures for Investors", which will require registrants to provide certain climate-related information in their registration statements and annual reports, including information about a registrant’s climate-related risks that have materially impacted, or are reasonably likely to have a material impact on, its business strategy, results of operations, or financial condition, as well as certain disclosures related to severe weather events and other natural conditions in a registrant’s audited financial statements. The disclosure requirements follow a phase-in timeline, with initial requirements beginning with the Company's annual report for the year ending December 31, 2025. On April 4, 2024, the SEC voluntarily stayed implementation of this new rule pending judicial review. The Company is currently analyzing the impact that the new climate-related rules will have on the disclosures within its consolidated financial statements and will continue to monitor the status of the rules while legal challenges are pending.
3. Investments and Fair Value of Financial Instruments
Marketable and Non-Marketable Investments
The Company’s marketable and non-marketable investments have been classified and accounted for as available-for-sale. The Company’s marketable and non-marketable investments as of March 31, 2024 and December 31, 2023 were as follows (in thousands):
8

Penumbra, Inc.
Notes to Condensed Consolidated Financial Statements
(unaudited)
March 31, 2024
Securities with net gains or losses in accumulated other comprehensive income (loss)
Amortized CostGross Unrealized GainsGross Unrealized LossesAllowance
 for
 Credit Loss
Fair Value
Marketable investments:
Commercial paper $31,449 $7 $(11)$ $31,445 
Certificate of Deposit4,632 4   4,636 
U.S. treasury13,210  (142)$ 13,068 
U.S. states and municipalities900  (9) 891 
Corporate bonds40,542 19 (241) 40,320 
Total90,733 30 (403) 90,360 
Non-marketable investments:
Non-marketable debt securities10,000    10,000 
Total10,000    10,000 
Total $100,733 $30 $(403)$ $100,360 
December 31, 2023
Securities with net gains or losses in accumulated other comprehensive income (loss)
Amortized CostGross Unrealized GainsGross Unrealized LossesAllowance
 for
 Credit Loss
Fair Value
Marketable investments:
Commercial paper $39,727 $32 $(3)$ $39,756 
Certificate of Deposit6,392 9   6,401 
U.S. treasury10,226  (160) 10,066 
U.S. states and municipalities2,950  (35) 2,915 
Corporate bonds62,964 29 (430) 62,563 
Total$122,259 $70 $(628)$ $121,701 
As of March 31, 2024, the total amortized cost basis of the Company’s available-for-sale debt securities, excluding non-marketable debt securities, is an unrealized loss position of $0.4 million, which was primarily attributable to rising interest rates since purchase. The Company reviewed its available-for-sale securities in an unrealized loss position and concluded that the decline in fair value was not related to credit losses and is recoverable. During the three months ended March 31, 2024, no allowance for credit losses was recorded and instead the unrealized losses are reported as a component of accumulated other comprehensive loss.
9

Penumbra, Inc.
Notes to Condensed Consolidated Financial Statements
(unaudited)
The following tables present the gross unrealized losses and the fair value for those marketable investments that were in an unrealized loss position for less than and more twelve months as of March 31, 2024 and December 31, 2023 (in thousands):
March 31, 2024
Less than 12 monthsMore than 12 monthsTotal
Fair ValueGross Unrealized LossesFair ValueGross Unrealized LossesFair ValueGross Unrealized Losses
Marketable investments:
Commercial paper$20,041 $(11)$ $ $20,041 $(11)
U.S. treasury5,666 (80)4,436 (62)10,102 (142)
U.S. states and municipalities  891 (9)891 (9)
Corporate bonds2,998 (3)13,421 (238)16,419 (241)
Total$28,705 $(94)$18,748 $(309)$47,453 $(403)
December 31, 2023
Less than 12 monthsMore than 12 monthsTotal
Fair ValueGross Unrealized LossesFair ValueGross Unrealized LossesFair ValueGross Unrealized Losses
Marketable investments:
Commercial paper$16,241 $(3)$ $ $16,241 $(3)
U.S. treasury5,677 (54)4,389 (106)10,066 (160)
U.S. states and municipalities  2,915 (35)2,915 (35)
Corporate bonds15,945 (2)30,912 (428)46,857 (430)
Total$37,863 $(59)$38,216 $(569)$76,079 $(628)
The contractual maturities of the Company’s marketable investments as of March 31, 2024 (in thousands):
March 31, 2024
Marketable investments:Amortized CostFair Value
Due in one year$87,922 $87,601 
Due in one to five years2,811 2,759 
Total$90,733 $90,360 
Non-Marketable Investments
During the three months ended March 31, 2024, the Company completed a strategic investment in a privately held company. Under the terms of the investment, the Company paid $10.0 million in exchange for shares of Series B preferred stock which represented an immaterial investment in the investment in outstanding equity securities of the privately held company. The Company determined that the investment did not meet the criteria to be accounted for as an equity method investment under ASC 323. The investment was accounted for as an available-for-sale debt security in accordance with ASC 320 as the preferred stock contains a contingent redemption feature at the Company’s option. The investment is included in other non-current assets on the condensed consolidated balance sheet and changes in fair value are recorded in total other comprehensive (loss) income, net of tax. There were no unrealized gains or losses recorded in connection with the Company’s non-marketable debt securities during the three months ended March 31, 2024.
Fair Value of Financial Instruments
Fair value is defined as the price that would be received to sell an asset or paid to transfer a liability (an exit price) in an orderly transaction between market participants at the reporting date. The accounting guidance establishes a three-tiered hierarchy, which prioritizes the inputs used in the valuation methodologies in measuring fair value:
Level 1 - Quoted prices in active markets for identical assets or liabilities.
10

Penumbra, Inc.
Notes to Condensed Consolidated Financial Statements
(unaudited)
Level 2 - Inputs other than Level 1 that are observable, either directly or indirectly, such as quoted prices in markets that are not active; or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities.
Level 3 - Unobservable inputs that are supported by little or no market activity and that are significant to the fair value of the assets or liabilities.
The categorization of a financial instrument within the valuation hierarchy is based on the lowest level of input that is significant to the fair value measurement.
The Company classifies its cash equivalents and marketable investments within Level 1 and Level 2, as it uses quoted market prices or alternative pricing sources and models utilizing market observable inputs. The Company classifies its non-marketable investments in preferred stock in privately held companies within Level 3, as they do not have a readily determinable fair value.
The Company determined the fair value of its Level 1 financial instruments, which are traded in active markets, using quoted market prices for identical instruments.
Marketable investments classified within Level 2 of the fair value hierarchy are valued based on other observable inputs, including broker or dealer quotations or alternative pricing sources. When quoted prices in active markets for identical assets or liabilities are not available, the Company relies on non-binding quotes from its investment managers, which are based on proprietary valuation models of independent pricing services. These models generally use inputs such as observable market data, quoted market prices for similar instruments, historical pricing trends of a security as relative to its peers. To validate the fair value determination provided by its investment managers, the Company reviews the pricing movement in the context of overall market trends and trading information from its investment managers. In addition, the Company assesses the inputs and methods used in determining the fair value in order to determine the classification of securities in the fair value hierarchy.
Non-marketable investments classified within Level 3 of the fair value hierarchy are valued based on unobservable inputs that are supported by little or no market activity. Current financial information of private companies may not be available and consequently the Company estimates the fair value using inputs that are based on the best available information at the measurement date, which may include the most recent financial information, financial projections, and financing transactions available for the investee and other quantitative and qualitative factors. Additionally, based on the timing, volume, and other characteristics of the available information, the Company may supplement this information by using one or more valuation techniques, including market and income approaches. The Company did not hold any non-marketable investments classified as Level 3 as of December 31, 2023.
The Company did not hold any Level 3 marketable investments as of March 31, 2024 or December 31, 2023. During the three months ended March 31, 2024 and 2023, the Company did not have any transfers between Level 1, Level 2 or Level 3 of the fair value hierarchy. Additionally, the Company did not have any financial assets and liabilities measured at fair value on a non-recurring basis as of March 31, 2024 or December 31, 2023.
11

Penumbra, Inc.
Notes to Condensed Consolidated Financial Statements
(unaudited)
The following tables set forth the Company’s financial assets and liabilities measured at fair value by level within the fair value hierarchy as of March 31, 2024 and December 31, 2023 (in thousands):
 As of March 31, 2024
 Level 1Level 2Level 3Fair Value
Financial Assets
Cash equivalents:
Commercial paper$ $30,555 $ $30,555 
Certificate of deposit 4,901  4,901 
Money market funds57,278   57,278 
U.S. treasury53,672   53,672 
Marketable investments:
Commercial paper 31,445  31,445 
Certificate of deposit 4,636  4,636 
U.S. treasury13,068   13,068 
U.S. states and municipalities 891  891 
Corporate bonds 40,320  40,320 
Non-marketable investments:
Non-marketable investments  10,000 10,000 
Total$124,018 $112,748 $10,000 $246,766 
 As of December 31, 2023
 Level 1Level 2Level 3Fair Value
Financial Assets
Cash equivalents:
Money market funds$86,991 $ $ $86,991 
Marketable investments:
Commercial paper 39,756  39,756 
Certificate of Deposit 6,401  6,401 
U.S. treasury10,066   10,066 
U.S. states and municipalities 2,915  2,915 
Corporate bonds 62,563  62,563 
Total$97,057 $111,635 $ $208,692 

4. Balance Sheet Components
Inventories
The components of inventories consisted of the following (in thousands):
 March 31, 2024December 31, 2023
Raw materials$121,134 $119,511 
Work in process36,815 34,489 
Finished goods240,417 234,023 
Inventories$398,366 $388,023 
12

Penumbra, Inc.
Notes to Condensed Consolidated Financial Statements
(unaudited)
Accrued Liabilities
The components of accrued liabilities consisted of the following (in thousands):
 March 31, 2024December 31, 2023
Payroll and employee-related expenses$59,481 $65,395 
Accrued expenses14,327 11,711 
Deferred revenue8,672 6,985 
Other accrued liabilities24,069 26,464 
Total accrued liabilities$106,549 $110,555 
The following table shows the changes in the Company’s estimated product warranty accrual, included in accrued liabilities, for the three months ended March 31, 2024 and twelve months ended December 31, 2023, respectively (in thousands):
 March 31, 2024December 31, 2023
Balance at the beginning of the period$5,755 $5,370 
Accruals of warranties issued, net(3,141)1,865 
Settlements of warranty claims(536)(1,480)
Balance at the end of the period$2,078 $5,755 
5. Intangible Assets
The following table presents details of the Company’s acquired intangible assets as of March 31, 2024 and December 31, 2023 (in thousands, except weighted-average amortization period):
As of March 31, 2024Weighted-Average Amortization PeriodGross Carrying AmountAccumulated AmortizationNet
Finite-lived intangible assets:
Developed technology8.8 years$83,289 $(22,020)$61,269 
Customer relationships15.0 years6,434 (2,895)3,539 
Trade secrets and processes20.0 years5,256 (1,643)3,613 
Total intangible assets 9.6 years$94,979 $(26,558)$68,421 
As of December 31, 2023Weighted-Average
Amortization Period
Gross Carrying AmountAccumulated AmortizationNet
Finite-lived intangible assets:
Developed technology8.8 years$83,289 $(19,640)$63,649 
Customer relationships15.0 years6,579 (2,851)3,728 
Trade secrets and processes20.0 years5,256 (1,577)3,679 
Total intangible assets9.6 years$95,124 $(24,068)$71,056 
The gross carrying amount and accumulated amortization of the customer relationships are the only intangible assets subject to foreign currency translation effects. The Company’s $5.3 million trade secrets and processes intangible asset was recognized in connection with a royalty buyout agreement in 2018.
The following table presents the amortization recorded related to the Company’s finite-lived intangible assets for the three months ended March 31, 2024 and 2023 (in thousands):
13

Penumbra, Inc.
Notes to Condensed Consolidated Financial Statements
(unaudited)
 Three Months Ended March 31,
 20242023
Cost of revenue$66 $66 
Sales, general and administrative2,487 2,486 
Total$2,553 $2,552 
6. Goodwill
The following table presents the changes in goodwill during the three months ended March 31, 2024 (in thousands):
Total Company
Balance as of December 31, 2023$166,270 
Foreign currency translation (167)
Balance as of March 31, 2024$166,103 
Goodwill Impairment Review
The Company reviews goodwill for impairment annually on October 31, or more frequently if events or circumstances indicate that an impairment loss may have occurred. The Company determined there were no impairment indicators as of March 31, 2024.
7. Indebtedness
Credit Agreement
On April 24, 2020, the Company entered into a Credit Agreement (the “Credit Agreement”) with JPMorgan Chase Bank, N.A., as administrative agent and lender, and Bank of America, N.A. and Citibank, N.A. as lenders. The Credit Agreement was secured and provided for up to $100 million in available revolving borrowing capacity with an option, subject to certain conditions, for the Company to increase the aggregate borrowing capacity to up to $150 million, and originally matured on April 23, 2021. During the three months ended March 31, 2021, 2022 and 2023, the Credit Agreement was amended to extend the maturity date and make other changes to the terms of the Credit Agreement. The Credit Agreement matured on February 16, 2024 and was not renewed.
8. Commitments and Contingencies
Royalty Obligations
In March 2005, the Company entered into a license agreement that requires the Company to make minimum royalty payments to the licensor on a quarterly basis. As of December 31, 2018, the license agreement required minimum annual royalty payments of $0.1 million in equal quarterly installments. In July 2019, the Company amended the license agreement to extend its term for an additional ten years and to increase the required minimum annual royalty payments by $0.2 million for a required minimum annual royalty payment of $0.3 million. Unless terminated earlier, the term of the amended license agreement shall expire June 30, 2029.
Royalty expense included in cost of sales for the three months ended March 31, 2024 and 2023 was $0.6 million and $0.7 million, respectively.
Contingencies
From time to time, the Company may have certain contingent liabilities that arise in the ordinary course of business. The Company accrues a liability for such matters when it is probable that future expenditures will be made and such expenditures can be reasonably estimated.
Indemnification
The Company enters into standard indemnification arrangements in the ordinary course of business. In many such arrangements, the Company agrees to indemnify, hold harmless, and reimburse the indemnified parties for losses suffered or
14

Penumbra, Inc.
Notes to Condensed Consolidated Financial Statements
(unaudited)
incurred by the indemnified parties in connection with any trade secret, copyright, patent or other intellectual property infringement claim by any third-party with respect to the Company’s technology. The Company also agrees to indemnify many indemnified parties for product defect and similar claims. The term of these indemnification agreements is generally perpetual. The maximum potential amount of future payments the Company could be required to make under these agreements is not determinable because it involves claims that may be made against the Company in the future, but have not yet been made.
The Company has entered into indemnification agreements with its directors and officers that may require the Company to indemnify its directors and officers against liabilities that may arise by reason of their status or service as directors or officers, other than liabilities arising from willful misconduct of the individual.
The Company has not incurred costs to defend lawsuits or settle claims related to these indemnification agreements. No liability associated with any of these indemnification requirements has been recorded to date.
Litigation
From time to time, the Company is subject to certain legal proceedings, as well as demands, claims and threatened litigation that arise in the normal course of our business. The Company reviews the status of each significant matter quarterly and assesses its potential financial exposure. If the potential loss from a claim or legal proceeding is considered probable and the amount can be reasonably estimated, the Company records a liability and an expense for the estimated loss and discloses it in the Company’s financial statements if it is significant. If the Company determines that a loss is possible and the range of the loss can be reasonably determined, the Company does not record a liability or an expense but the Company discloses the range of the possible loss. The Company bases its judgments on the best information available at the time. As additional information becomes available, the Company reassesses the potential liability related to its pending claims and litigation and may revise its estimates.
On April 7, 2023, a former contractor who had been retained by the Company through a third party staffing agency filed a putative class action lawsuit as well as a Private Attorney General Act (“PAGA”) representative action complaint against the Company in the Superior Court of the State of California for the County of Alameda, on behalf of the contractor and similarly situated Company contractors and employees in California, alleging various claims pursuant to the California Labor Code related to wages, overtime, meal and rest breaks, reimbursement of business expenses, wage statements and records, and other similar allegations. Additionally, on April 10, 2023, a current employee of the Company filed a PAGA representative action complaint against the Company in the Superior Court of the State of California for the County of Alameda, on behalf of the employee and similarly situated Company employees in California, alleging similar claims. The complaints seek payment of various alleged unpaid wages, penalties, interest and attorneys’ fees in unspecified amounts. On April 22, 2024, the Company engaged in mediation, following which the parties agreed to settle the claims for an aggregate amount of $4.6 million, subject to negotiation of a mutually agreeable settlement agreement and approval by the court. As a result, the Company recorded an accrual of $4.6 million in its financial statements for the three months ended March 31, 2024 related to these matters.
9. Stockholders’ Equity
Stock-based Compensation
Stock-based compensation expense is associated with restricted stock units (“RSUs”), RSUs with performance conditions (“PSUs”), stock options, and the Company’s Employee Stock Purchase Plan (“ESPP”).
Certain PSUs granted to senior management during the three months ended March 31, 2024, will vest subject to the achievement of pre-established financial performance targets for the year ending December 31, 2024, and continued service. The fair value of these PSUs is based on the closing price of the Company's common stock on the date of grant. Stock-based compensation costs associated with these PSUs are recognized over the requisite service period of 4.25 years using graded vesting which results in more accelerated expense recognition compared to traditional time-based vesting over the same vesting period. Each reporting period, the Company monitors the probability of achieving the performance targets and may adjust periodic stock-based compensation expense based on its determination of the likelihood of achieving these performance targets and the estimated number of shares of common stock that will vest. The actual number of PSUs awarded is based on the actual performance during the performance period compared to the performance targets.
The following table sets forth the stock-based compensation expense included in the Company’s condensed consolidated statements of operations for the three months ended March 31, 2024 and 2023 (in thousands):
15

Penumbra, Inc.
Notes to Condensed Consolidated Financial Statements
(unaudited)
 Three Months Ended March 31,
 20242023
Cost of revenue$1,194 $1,191 
Research and development2,168 2,278 
Sales, general and administrative10,207 9,297 
Total$13,569 $12,766 
As of March 31, 2024, total unrecognized compensation cost related to unvested share-based compensation arrangements, excluding PSUs, was $56.4 million, which is expected to be recognized over a weighted average period of 2.6 years.
As of March 31, 2024, total unrecognized compensation cost related to unvested PSU share-based compensation arrangements was $27.3 million, which is expected to be recognized over a weighted average period of 3.5 years.
The total stock-based compensation cost capitalized in inventory was $1.2 million and $1.3 million as of March 31, 2024 and December 31, 2023, respectively.
10. Accumulated Other Comprehensive Income
Other comprehensive (loss) income consists of two components: unrealized gains or losses on the Company’s available-for-sale marketable investments and gains or losses from foreign currency translation adjustments. Until realized and reported as a component of consolidated net income, these comprehensive income items accumulate and are included within accumulated other comprehensive income. Unrealized gains and losses on our marketable investments are reclassified from accumulated other comprehensive income into earnings when realized upon sale, and are determined based on specific identification of securities sold. Gains and losses from the translation of assets and liabilities denominated in non-U.S. dollar functional currencies are included in accumulated other comprehensive income.
The following table summarizes the changes in the accumulated balances during the period, and includes information regarding the manner in which the reclassifications out of accumulated other comprehensive income into earnings affect our condensed consolidated statements of comprehensive income (loss) (in thousands):    
Three Months Ended March 31, 2024Three Months Ended March 31, 2023
 Marketable
Investments
 Currency Translation
Adjustments
 Total Marketable
Investments
 Currency Translation
Adjustments
 Total
Balance, beginning of the period$(558)$(2,593)$(3,151)$(3,500)$(4,624)$(8,124)
Other comprehensive loss before reclassifications:
Unrealized gains — marketable investments(1)
166  166 860  860 
Foreign currency translation (losses) gains (1,857)(1,857) 403 403 
Income tax effect — expense 4 4    
Net of tax166 (1,853)(1,687)860 403 1,263 
Net current-year other comprehensive income (loss)166 (1,853)(1,687)860 403 1,263 
Balance, end of the period$(392)$(4,446)$(4,838)$(2,640)$(4,221)$(6,861)
(1) There were no unrealized gains or losses recorded in connection with the Company’s non-marketable debt securities as of March 31, 2024.
11. Income Taxes
The Company’s income tax expense (benefit), deferred tax assets and liabilities, and reserves for unrecognized tax benefits reflect management’s best assessment of estimated current and future taxes to be paid. The Company is subject to income taxes in both the United States and foreign jurisdictions. Significant judgment and estimates are required in determining the consolidated income tax expense (benefit).
During interim periods, the Company generally utilizes the estimated annual effective tax rate (“AETR”) method which involves the use of forecasted information. Under the AETR method, the provision is calculated by applying the estimated
16

Penumbra, Inc.
Notes to Condensed Consolidated Financial Statements
(unaudited)
AETR for the full fiscal year to “ordinary” income or loss (pretax income or loss excluding unusual or infrequently occurring discrete items) for the reporting period. Jurisdictions with tax assets for which the Company believes a tax benefit cannot be realized are excluded from the computation of its AETR.
The Company’s provision for income taxes was $3.6 million for the three months ended March 31, 2024, compared to $0.1 million for the three months ended March 31, 2023. The effective tax rate was 24.8% for the three months ended March 31, 2024, compared to 1.0% for the three months ended March 31, 2023. The change in effective tax rate was primarily attributable to an increase in tax expense due to profit increase and a decrease in excess tax benefits from stock-based compensation attributable to its U.S. jurisdiction.
Significant domestic deferred tax assets (“DTAs”) were generated in recent years, primarily due to excess tax benefits from stock option exercises and vesting of restricted stock units. The Company evaluates all available positive and negative evidence, objective and subjective in nature, in each reporting period to determine if sufficient taxable income will be generated to realize the benefits of its DTAs and, if not, a valuation allowance to reduce the DTAs is recorded.
As of March 31, 2024, the Company maintains a valuation allowance primarily against its California R&D tax credit DTAs for which the Company does not believe a tax benefit is more likely than not to be realized due to the computation of California taxes under the single sales factor and non-conformity of the Section 174 capitalization rule.
The Company maintains that all foreign earnings, with the exception of a portion of the earnings of its German subsidiary, are permanently reinvested outside the United States and therefore deferred taxes attributable to such earnings are not provided for in the Company’s condensed consolidated financial statements as of March 31, 2024.
12. Net Income per Share
The Company computed basic net income per share based on the weighted average number of shares of common stock outstanding during the period. The Company computed diluted net income per share based on the weighted average number of shares of common stock outstanding plus potentially dilutive common stock equivalents outstanding during the period. For the purposes of this calculation, stock options, restricted stock units, performance stock units, and stock sold through the ESPP are considered common stock equivalents.
A reconciliation of the numerator and denominator used in the calculation of the basic and diluted net income per share is as follows (in thousands, except share and per share amounts):
 Three Months Ended March 31,
 20242023
Numerator:
Net income$11,002 $8,562 
Denominator:
Weighted average shares used to compute net income attributable to common stockholders:
Basic38,717,334 38,186,342 
Potential dilutive stock-based options and awards670,025 889,046 
Diluted39,387,359 39,075,388 
Net income per share:
Basic$0.28 $0.22 
Diluted$0.28 $0.22 
For the three months ended March 31, 2024 and 2023, outstanding stock-based awards of 26 thousand and 26 thousand shares, respectively, were excluded from the computation of diluted net income per share because their effect would have been anti-dilutive in the periods presented.
13. Interest and other income (expense), net
17

Penumbra, Inc.
Notes to Condensed Consolidated Financial Statements
(unaudited)
The following table shows the components of interest and other income (expense), net for the three months ended March 31, 2024 and 2023 and (in thousands):
 Three Months Ended March 31,
 20242023
Interest income$3,293 $970 
Interest expense(402)(416)
Other income (expense), net(1)
(366)90 
Interest and other income, net$2,525 $644 
(1) Consists primarily of the effects of foreign currency gains or losses.
14. Revenues
Revenue Recognition
Revenue is recognized in an amount that reflects the consideration the Company expects to be entitled to in exchange for goods or services. All revenue recognized in the condensed consolidated statements of operations is considered to be revenue from contracts with customers.
Certain changes in presentation were made to the Company’s revenues disaggregated by product categories for the period ended March 31, 2023 to conform to the presentation for the period ended March 31, 2024. During the year ended December 31, 2023, the Company made changes to its product categories to provide investors with more meaningful information to understand the performance of its business and strategic direction.
The Company’s revenues disaggregated by geography, based on the destination to which the Company ships its products, for the three months ended March 31, 2024 and 2023 was as follows (in thousands):
 Three Months Ended March 31,
 20242023
United States$209,644 $171,879 
International69,011 69,519 
Total$278,655 $241,398 
The Company’s revenues disaggregated by product category for the three months ended March 31, 2024 and 2023 was as follows (in thousands):
 Three Months Ended March 31,
 20242023
Thrombectomy$187,703 $144,980 
Embolization and Access90,952 96,418 
Total$278,655 $241,398 
Performance Obligations
Delivery of products - The Company’s contracts with customers, other than the China licensing arrangements described below, typically contain a single performance obligation, delivery of the Company’s products. Satisfaction of that performance obligation occurs when control of the promised goods transfers to the customer, which is generally upon shipment or receipt by customer for non-consignment sale agreements and upon utilization for consignment sale agreements.
Payment terms - The Company’s payment terms vary by the type and location of our customer. The timing between fulfillment of performance obligations and when payment is due is not significant and does not give rise to financing transactions. The Company did not have any contracts with significant financing components as of March 31, 2024 and 2023.
Product returns - The Company may allow customers to return products purchased at the Company’s discretion. The Company estimates the amount of its product sales that may be returned by its customers and records this estimate as a
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Penumbra, Inc.
Notes to Condensed Consolidated Financial Statements
(unaudited)
reduction of revenue in the period in which the related product revenue is recognized. The Company currently estimates product return liabilities using its own historic sales information, trends, industry data, and other relevant data points.
Warranties - The Company offers its standard warranty to all customers and it is not available for sale on a standalone basis. The Company’s standard warranty represents its guarantee that its products function as intended, are free from defects, and comply with agreed-upon specifications and quality standards. This assurance does not constitute a service and is not a separate performance obligation.
Transaction Price
Revenue is recorded at the net sales price, which includes estimates of variable consideration such as product returns utilizing historical return rates, rebates, discounts, and other adjustments to net revenue. To the extent the transaction price includes variable consideration, the Company estimates the amount of variable consideration that should be included in the transaction price. When determining if variable consideration should be constrained, management considers whether there are factors that could result in a significant reversal of revenue and the likelihood of a potential reversal. Variable consideration is included in revenue only to the extent that it is probable that a significant reversal of the revenue recognized will not occur when the uncertainty associated with the variable consideration is subsequently resolved. These estimates are reassessed each reporting period as required. During the three months ended March 31, 2024 and 2023, the Company made no material changes in estimates for variable consideration. When the Company performs shipping and handling activities after control of goods is transferred to the customer, they are considered as fulfillment activities, and costs are accrued for when the related revenue is recognized. Taxes collected from customers relating to product sales and remitted to governmental authorities are excluded from revenues.
Contract assets and liabilities
The following information summarizes the Company’s contract assets and liabilities (in thousands):
March 31, 2024December 31, 2023
Contract assets$18,000 $18,000 
Contract liabilities$7,261 $6,496 
Contract assets for the periods presented primarily represent the difference between the revenue that was recognized based on the relative standalone selling price of the related performance obligations satisfied and the contractual billing terms in the licensing arrangements.
Contract liabilities represents amounts that the Company has already invoiced and are ultimately expected to be recognized as revenue, but for which not all revenue recognition criteria have been met and is recognized as the associated performance obligations are satisfied.
China Distribution and Technology Licensing Agreement
In December 2020, the Company entered into a distribution and technology licensing arrangement with its existing distribution partner in China. In addition to modifying the Company’s standard distribution agreement with its partner in China, the Company agreed to license the technology for certain products to its partner in China to permit the manufacturing and commercialization of such products in China as well as provide certain regulatory support. During the three months ended March 31, 2022, the Company further amended the distribution agreement and entered into an additional license arrangement, pursuant to which the Company agreed to license the technology for additional products to its partner in China on substantially the same terms as the existing license arrangement. Apart from the standard distribution agreement, the Company will receive fixed payments upon transferring its distinct licensed technology and providing related regulatory support. During the three months ended September 30, 2023, the Company entered into an additional licensing arrangement, pursuant to which the Company agreed to license the technology for additional products to its partner in China and will receive fixed payments upon transferring its distinct licensed technology and providing related regulatory support and royalty payments on the down-stream sale of the licensed products. During the three months ended March 31, 2024, the Company entered into another licensing agreement, pursuant to which the Company agreed to license the technology for additional products to its partner in China and will receive fixed payments upon transferring its distinct licensed technology and providing related regulatory support.

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ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS.
The following discussion and analysis of our financial condition and results of operations should be read in conjunction with the unaudited condensed consolidated financial statements and the related notes thereto included elsewhere in this Quarterly Report on Form 10-Q and the audited consolidated financial statements and notes thereto and management’s discussion and analysis of financial condition and results of operations for the year ended December 31, 2023, included in our Annual Report on Form 10-K filed with the Securities and Exchange Commission (“SEC”) on February 22, 2024.
This Quarterly Report on Form 10-Q contains “forward-looking statements” within the meaning of Section 21E of the Securities Exchange Act of 1934, as amended (the “Exchange Act”). In some cases, you can identify these statements by forward-looking words such as “may,” “will,” “expect,” “believe,” “anticipate,” “intend,” “could,” “should,” “estimate,” or “continue,” and similar expressions or variations, but these words are not the exclusive means for identifying such statements. Such forward-looking statements are subject to risks, uncertainties and other factors that could cause actual results and the timing of certain events to differ materially from future results and timing expressed or implied by such forward-looking statements. Factors that could cause or contribute to such differences include, but are not limited to, those identified below, and those discussed in the section titled “Risk Factors” in Part I, Item 1A of our Annual Report on Form 10-K for the year ended December 31, 2023. The forward-looking statements in this Quarterly Report on Form 10-Q represent our views as of the date of this Quarterly Report on Form 10-Q. Except as may be required by law, we assume no obligation to update these forward-looking statements or the reasons that results could differ from these forward-looking statements. You should, therefore, not rely on these forward-looking statements as representing our views as of any date subsequent to the date of this Quarterly Report on Form 10-Q.
Overview
References herein to “we,” “us,” “our,” the “Company,” and “Penumbra,” refer to Penumbra, Inc. and its consolidated subsidiaries unless expressly indicated or the context requires otherwise.
Penumbra is a global healthcare company focused on innovative therapies. We design, develop, manufacture and market novel products and have a broad portfolio that addresses challenging medical conditions in markets with significant unmet need. Our team focuses on developing, manufacturing and marketing novel products for use by specialist physicians and healthcare providers to drive improved clinical and health outcomes. We believe that the cost-effectiveness of our products is attractive to our customers.
Since our founding in 2004, we have invested heavily in our product development and commercial expansion that has established the foundation of our global organization. We have successfully developed, obtained regulatory clearance or approval for, and introduced products into the thrombectomy market since 2007, access market since 2008, embolization market since 2011, neurosurgical market since 2014, and immersive healthcare market since 2020.
We expect to continue to develop and build our portfolio of products, including our thrombectomy, embolization, access and immersive healthcare technologies, while iterating on our currently available products. Generally, when we introduce a next generation product or a new product designed to replace a current product, sales of the earlier generation product or the product replaced decline. Our research and development activities are centered around the development of new products and clinical activities designed to support our regulatory submissions and demonstrate the effectiveness of our products.
To address the challenging and significant clinical needs of our key markets, we have developed products that fall into the following broad product families:
Our thrombectomy products fall into two broad product families:
Peripheral thrombectomy - INDIGO System, including Lightning, Bolt and CAT RX, designed for continuous or modulated aspiration, computer-assisted vacuum thrombectomy, including aspiration catheters, microprocessor-controlled software algorithms that orchestrate the interaction of our pump and catheters, separators, aspiration pump and accessories, including delivery catheters used in peripheral thrombectomy procedures
Neuro thrombectomy - Penumbra System, Penumbra RED, JET, ACE, and BMX, MAX catheters and the 3D Revascularization Device, Penumbra ENGINE and other components and accessories
Our embolization and access products fall into four broad product families:
Peripheral embolization - RUBY Coil System, Ruby LP, LANTERN Delivery Microcatheter and the POD System (POD and POD Packing Coil)
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Neuro embolization - Penumbra SMART COIL, Penumbra Coil 400, POD400 and PAC400
Access - delivery catheters, consisting of Neuron, Neuron MAX Select, BENCHMARK, BMX, DDC, PX SLIM and SENDit
Neurosurgical - Artemis Neuro Evacuation Device
Our immersive healthcare products fall into one broad product family:
REAL Immersive System - portfolio of products that leverages immersive computer-based technologies to deliver engaging, immersive therapeutics to promote better health, motor function and cognition
We support healthcare providers, hospitals and clinics in more than 100 countries. In the three months ended March 31, 2024 and 2023, 24.8% and 28.8% of our revenue, respectively, was generated from customers located outside of the United States. Our sales outside of the United States are denominated principally in the euro, with some sales being denominated in other currencies. As a result, we have foreign exchange exposure but do not currently engage in hedging.
We generated revenue of $278.7 million and $241.4 million for the three months ended March 31, 2024 and 2023, respectively, an increase of $37.3 million. We generated income from operations of $12.1 million and $8.0 million for the three months ended March 31, 2024 and 2023, respectively.
Factors Affecting Our Performance
There are a number of factors that have impacted, and we believe will continue to impact, our results of operations and growth. These factors include: 
The rate at which we grow our salesforce and the speed at which newly hired salespeople become fully effective can impact our revenue growth or our costs incurred in anticipation of such growth.
Our industry is intensely competitive and, in particular, we compete with a number of large, well-capitalized companies. We must continue to successfully compete in light of our competitors’ existing and future products and their resources to successfully market to the specialist physicians who use our products.
We must continue to successfully introduce new products that gain acceptance with specialist physicians and other healthcare providers and successfully transition from existing products to new products, ensuring adequate supply. In addition, as we introduce new products and expand our production capacity, we anticipate additional personnel will be hired and trained to build our inventory of components and finished goods in advance of sales, which may cause quarterly fluctuations in our operating results and financial condition.
Publications of clinical results by us, our competitors and other third parties can have a significant influence on whether, and the degree to which, our products are used by specialist physicians and the procedures and treatments those physicians choose to administer for a given condition.
The specialist physicians who use our interventional products may not perform procedures during certain times of the year, such as those periods when they are at major medical conferences or are away from their practices for other reasons, the timing of which occurs irregularly during the year and from year to year.
Most of our sales outside of the United States are denominated in the local currency of the country in which we sell our products. As a result, our revenue from international sales can be significantly impacted by fluctuations in foreign currency exchange rates.
The availability and levels of reimbursement within the relevant healthcare payment system for healthcare providers for procedures in which our products are used.
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In addition, we have experienced and expect to continue to experience meaningful variability in our quarterly revenue, gross profit and gross margin percentage as a result of a number of factors, including, but not limited to: the number of available selling days, which can be impacted by holidays; the mix of products sold; the geographic mix of where products are sold; the demand for our products and the products of our competitors; the timing of or failure to obtain regulatory approvals or clearances for products; increased competition; the timing of customer orders; inventory write-offs due to obsolescence; costs, benefits and timing of new product introductions; costs, benefits and timing of the acquisition and integration of businesses and product lines we may acquire; the availability and cost of components and raw materials; and fluctuations in foreign currency exchange rates. We may experience quarters in which we have significant revenue growth sequentially followed by quarters of moderate or no revenue growth. Additionally, we may experience quarters in which operating expenses, in particular research and development expenses, fluctuate depending on the stage and timing of product development.
Components of Results of Operations
Revenue. We sell our interventional products directly to hospitals and other healthcare providers and through distributors for use in procedures performed by specialist physicians to treat patients in two key markets: thrombectomy and embolization and access. We sell our products through purchase orders, and we do not have long term purchase commitments from our customers. Revenue from product sales is recognized either on the date of shipment or the date of receipt by the customer, but is deferred for certain transactions when control has not yet transferred. With respect to products that we consign to hospitals, which primarily consist of coils, we recognize revenue at the time hospitals utilize products in a procedure. Revenue also includes shipping and handling costs that we charge to customers.
Cost of Revenue. Cost of revenue consists primarily of the cost of raw materials and components, personnel costs, including stock-based compensation, inbound freight charges, receiving costs, inspection and testing costs, warehousing costs, royalty expense, shipping and handling costs, and other labor and overhead costs incurred in the manufacturing of products. We manufacture substantially all of our products in our manufacturing facilities in Alameda and Roseville, California.
Operating Expenses
Research and Development (“R&D”). R&D expenses primarily consist of product development, clinical and regulatory expenses, materials, depreciation and other costs associated with the development of our products. R&D expenses also include salaries, benefits and other related costs, including stock-based compensation, for personnel and consultants. We expense R&D costs as they are incurred.
Sales, General and Administrative (“SG&A”). SG&A expenses primarily consist of salaries, benefits and other related costs, including stock-based compensation, for personnel and consultants engaged in sales, marketing, finance, legal, compliance, administrative, facilities and information technology and human resource activities. Our SG&A expenses also include marketing trials, medical education, training, commissions, generally based on sales, to direct sales representatives, amortization of acquired intangible assets and acquisition-related costs.
Income Taxes
We are taxed at the rates applicable within each jurisdiction in which we operate. The composite income tax rate, tax provisions, deferred tax assets (“DTAs”) and deferred tax liabilities will vary according to the jurisdiction in which profits arise. Tax laws are complex and subject to different interpretations by management and the respective governmental taxing authorities, and require us to exercise judgment in determining our income tax provision, our deferred tax assets and deferred tax liabilities and the potential valuation allowance recorded against our net DTAs. Deferred tax assets and liabilities are determined using the enacted tax rates in effect for the years in which those tax assets are expected to be realized. A valuation allowance is established when it is more likely than not that the future realization of all or some of the DTAs will not be achieved.
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Results of Operations
The following table sets forth the components of our condensed consolidated statements of operations in dollars and as a percentage of revenue for the periods presented:
 Three Months Ended March 31,
 20242023
 (in thousands, except for percentages)
Revenue$278,655 100.0 %$241,398 100.0 %
Cost of revenue97,516 35.0 90,326 37.4 
Gross profit181,139 65.0 151,072 62.6 
Operating expenses:
Research and development24,626 8.8 19,986 8.3 
Sales, general and administrative144,412 51.8 123,078 51.0 
Total operating expenses169,038 60.7 143,064 59.3 
Income from operations12,101 4.3 8,008 3.3 
Interest and other income, net2,525 0.9 644 0.3 
Income before income taxes14,626 5.2 8,652 3.6 
Provision for income taxes3,624 1.3 90 — 
Net income$11,002 3.9 %$8,562 3.5 %

Three Months Ended March 31, 2024 Compared to the Three Months Ended March 31, 2023
Certain changes in presentation were made to the Company’s revenues disaggregated by product categories for the period ended March 31, 2023 to conform to the presentation for the period ended March 31, 2024. During the year ended December 31, 2023, the Company made changes to its product categories to provide investors with more meaningful information to understand the performance of its business and strategic direction.
Revenue
 Three Months Ended March 31,Change
 20242023$%
 (in thousands, except for percentages)
Thrombectomy$187,703 $144,980 $42,723 29.5 %
Embolization and Access90,952 96,418 (5,466)(5.7)%
Total$278,655 $241,398 $37,257 15.4 %
Revenue increased $37.3 million, or 15.4%, to $278.7 million in the three months ended March 31, 2024, from $241.4 million in the three months ended March 31, 2023. Overall revenue growth was primarily due to an increase in sales of our existing thrombectomy products.
Revenue from our global thrombectomy products increased $42.7 million, or 29.5%, to $187.7 million in the three months ended March 31, 2024, from $145.0 million in the three months ended March 31, 2023. The increase in our global thrombectomy products was primarily attributable to higher sales volume in the United States as a result of sales and further market penetration of our existing products. This increase was driven by sales of our U.S. thrombectomy products, which increased by 35.2% in the three months ended March 31, 2024. Prices for our thrombectomy products remained substantially unchanged during the period.
Revenue from our global embolization and access products decreased $5.5 million, or 5.7%, to $91.0 million in the three months ended March 31, 2024, from $96.4 million in the three months ended March 31, 2023. The decrease in our global embolization and access products was primarily driven by our international embolization and access products, which decreased by 11.6% in the three months ended March 31, 2024. Prices for our embolization and access products remained substantially unchanged during the period.
Revenue by Geographic Area
The following table presents revenue by geographic area, based on our customers’ shipping destinations:
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Three Months Ended March 31,Change
20242023$%
 (in thousands, except for percentages)
United States$209,644 75.2 %$171,879 71.2 %$37,765 22.0 %
International69,011 24.8 %69,519 28.8 %(508)(0.7)%
Total$278,655 100.0 %$241,398 100.0 %$37,257 15.4 %
Revenue from product sales in international markets decreased $0.5 million, or 0.7%, to $69.0 million in the three months ended March 31, 2024, from $69.5 million in the three months ended March 31, 2023. Revenue from international sales represented 24.8% and 28.8% of our total revenue for the three months ended March 31, 2024 and 2023, respectively.
Gross Margin
 Three Months Ended March 31,Change
 20242023$%
 (in thousands, except for percentages)
Cost of revenue$97,516 $90,326 $7,190 8.0 %
Gross profit$181,139 $151,072 $30,067 19.9 %
Gross margin %65.0 %62.6 %
Gross margin increased by 2.4 percentage points to 65.0% in the three months ended March 31, 2024, from 62.6% in the three months ended March 31, 2023. Gross margin is impacted by product mix, regional mix, and production initiatives to support demand and create future efficiencies. As such, with favorable product mix, improvement in productivity, and by leveraging our fixed costs on higher volume of new product sales during the year, our gross margin may be positively impacted in the future.
Research and Development (“R&D”)
 Three Months Ended March 31,Change
 20242023$%
 (in thousands, except for percentages)
R&D$24,626 $19,986 $4,640 23.2 %
R&D as a percentage of revenue8.8 %8.3 %
R&D expenses increased by $4.6 million, or 23.2%, to $24.6 million in the three months ended March 31, 2024, from $20.0 million in the three months ended March 31, 2023. The increase was primarily due to a $2.0 million increase in personnel-related expenses driven by an increase in headcount and related expenses to support our growth and a $1.3 million increase in product development and testing costs.
We have continued to make investments, and plan to continue to make investments, in the development of our products. As part of our ongoing investment in the development of our products, we may incur additional expenses related to research and development milestones. In addition, we have experienced in the past, and may continue to experience in the future, variability in expenses incurred due to the timing and costs of clinical trials and product development, which may include additional personnel-related expenses in conjunction with the launch of new products.
Sales, General and Administrative (“SG&A”)
 Three Months Ended March 31,Change
 20242023$%
 (in thousands, except for percentages)
SG&A$144,412 $123,078 $21,334 17.3 %
SG&A as a percentage of revenue51.8 %51.0 %
SG&A expenses increased by $21.3 million, or 17.3%, to $144.4 million in the three months ended March 31, 2024, from $123.1 million in the three months ended March 31, 2023. The increase was primarily due to a $6.4 million increase in personnel-related expenses driven by an increase in headcount and related expenses to support our growth, $4.8 million in non-recurring litigation related expenses, including settlement costs and legal fees, associated with wage and hour complaints filed against the Company in 2023, a $3.0 million increase in costs related to marketing events, and a $2.1 million increase in other professional services.
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As we continue to invest in our growth, we have expanded and may continue to expand our sales, marketing, and general and administrative teams through the hiring of additional employees in critical roles that support our strategic initiatives. In addition, we have experienced in the past, and may continue to experience in the future, variability in expenses incurred due to the timing and costs of investments to support the business.
Provision for income taxes
 Three Months Ended March 31,Change
 20242023$%
 (in thousands, except for percentages)
Provision for income taxes$3,624 $90 $3,534 3,926.7 %
Effective tax rate24.8 %1.0 %
Our provision for income taxes was $3.6 million for the three months ended March 31, 2024, compared to $0.1 million for the three months ended March 31, 2023. Our effective tax rate was 24.8% for the three months ended March 31, 2024, compared to 1.0% for the three months ended March 31, 2023. The change in effective tax rate was primarily attributable to an increase in tax expense due to profit increase and a decrease in excess tax benefits from stock-based compensation attributable to our U.S. jurisdiction.
Prospectively, our effective tax rate will likely be driven by (1) permanent differences in taxable income for tax and financial reporting purposes, (2) tax expense or benefit attributable to our worldwide financial result, and (3) discrete tax adjustments such as excess tax benefits or deficiencies related to stock-based compensation. Our income tax provision is subject to volatility as the amount of excess tax benefits or deficiencies can fluctuate from period to period based on the price of our stock, the volume of share-based grants settled or vested, and the fair value assigned to equity awards under U.S. GAAP.

Liquidity and Capital Resources
As of March 31, 2024, we had $782.2 million in working capital, which included $223.1 million in cash and cash equivalents and $90.4 million in marketable investments. As of March 31, 2024, we held approximately 7.7% of our cash and cash equivalents in foreign entities.
We believe our current sources of liquidity will be sufficient to meet our liquidity requirements for at least the next 12 months. Our principal liquidity requirements are to fund our operations, expand manufacturing operations which includes, but is not limited to, maintaining sufficient levels of inventory to meet the anticipated demand of our customers, fund research and development activities and fund our capital expenditures. We may also lease or purchase additional facilities to facilitate our growth. We expect to continue to make investments as we launch new products, expand our manufacturing operations and information technology infrastructures and further expand into international markets. We may, however, require or elect to secure additional financing as we continue to execute our business strategy. If we require or elect to raise additional funds, we may do so through equity or debt financing, which may not be available on favorable terms, could result in dilution to our stockholders, and could require us to agree to covenants that limit our operating flexibility.
The following table summarizes our cash and cash equivalents, marketable investments and selected working capital data as of March 31, 2024 and December 31, 2023:
 March 31, 2024December 31, 2023
 (in thousands)
Cash and cash equivalents$223,114 $167,486 
Marketable investments90,360 121,701 
Accounts receivable, net191,989 201,768 
Accounts payable32,454 27,155 
Accrued liabilities106,549