CYTOKINETICS INC, 10-K filed on 2/28/2024
Annual Report
v3.24.0.1
Document and Entity Information - USD ($)
$ in Billions
12 Months Ended
Dec. 31, 2023
Feb. 27, 2024
Jun. 30, 2023
Cover [Abstract]      
Document Type 10-K    
Amendment Flag false    
Document Period End Date Dec. 31, 2023    
Document Fiscal Year Focus 2023    
Document Fiscal Period Focus FY    
Trading Symbol CYTK    
Entity Registrant Name CYTOKINETICS, INCORPORATED    
Entity Central Index Key 0001061983    
Current Fiscal Year End Date --12-31    
Entity Well-known Seasoned Issuer Yes    
Entity Current Reporting Status Yes    
Entity Voluntary Filers No    
Entity Filer Category Large Accelerated Filer    
Entity Small Business false    
Entity Emerging Growth Company false    
Entity Shell Company false    
Entity Common Stock, Shares Outstanding   103,004,710  
Entity Public Float     $ 2.0
Entity Interactive Data Current Yes    
Title of 12(b) Security Common Stock, $0.001 par value    
Security Exchange Name NASDAQ    
Entity File Number 000-50633    
Entity Incorporation, State or Country Code DE    
Entity Tax Identification Number 94-3291317    
Entity Address, Address Line One 350 Oyster Point Boulevard    
Entity Address, City or Town South San Francisco    
Entity Address, State or Province CA    
Entity Address, Postal Zip Code 94080    
City Area Code 650    
Local Phone Number 624-3000    
Document Annual Report true    
Document Transition Report false    
ICFR Auditor Attestation Flag true    
Document Financial Statement Error Correction [Flag] false    
Documents Incorporated by Reference

Portions of the Registrant’s Proxy Statement for its 2024 Annual Meeting of Stockholders to be filed with the Securities and Exchange Commission, no later than 120 days after the end of the fiscal year, are incorporated by reference into Part III of this Annual Report on Form 10-K.

   
Auditor Name Ernst & Young LLP    
Auditor Firm ID 42    
Auditor Location San Jose, California    
v3.24.0.1
Consolidated Balance Sheets - USD ($)
$ in Thousands
Dec. 31, 2023
Dec. 31, 2022
Current assets:    
Cash and cash equivalents $ 113,024 $ 65,582
Short-term investments 501,800 716,995
Accounts receivable 1,283 147
Prepaid expenses and other current assets 11,944 12,462
Total current assets 628,051 795,186
Long-term investments 40,534 46,708
Property and equipment, net 68,748 80,453
Operating lease right-of-use assets 78,987 82,737
Other assets 7,996 9,691
Total assets 824,316 1,014,775
Current liabilities:    
Accounts payable 21,507 25,611
Accrued liabilities 42,641 44,096
Short-term operating lease liabilities 17,891 12,829
Current portion of long-term debt 10,080 958
Other current liabilities 10,559 1,123
Total current liabilities 102,678 84,617
Term loan, net 58,384 63,810
Convertible notes, net 548,989 545,808
Liabilities related to revenue participation right purchase agreements, net 379,975 300,501
Long-term operating lease liabilities 120,427 126,895
Other non-current liabilities 186 1,044
Total liabilities 1,210,639 1,122,675
Commitments and contingencies
Stockholders' deficit:    
Preferred stock, $0.001 par value: Authorized: 10,000,000 shares; Issued and outstanding: none 0 0
Common stock, $0.001 par value: Authorized: 163,000,000 shares; Issued and outstanding: 101,637,922 shares at December 31, 2023 and 94,833,975 shares at December 31, 2022 102 94
Additional paid-in capital 1,725,823 1,481,590
Accumulated other comprehensive loss (10) (3,590)
Accumulated deficit (2,112,238) (1,585,994)
Total stockholders' deficit (386,323) (107,900)
Total liabilities and stockholders' deficit $ 824,316 $ 1,014,775
v3.24.0.1
Consolidated Balance Sheets (Parenthetical) - $ / shares
Dec. 31, 2023
Dec. 31, 2022
Statement of Financial Position [Abstract]    
Preferred stock, par value $ 0.001 $ 0.001
Preferred stock, shares authorized 10,000,000 10,000,000
Preferred stock, shares issued 0 0
Preferred stock, shares outstanding 0 0
Common stock, par value $ 0.001 $ 0.001
Common stock, shares authorized 163,000,000 163,000,000
Common stock, shares issued 101,637,922 94,833,975
Common stock, shares outstanding 101,637,922 94,833,975
v3.24.0.1
Consolidated Statements of Operations and Comprehensive Loss - USD ($)
$ in Thousands
12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Revenues:      
Total revenues $ 7,530 $ 94,588 $ 70,428
Operating expenses:      
Research and development 330,123 240,813 159,938
General and administrative 173,612 177,977 96,803
Total operating expenses 503,735 418,790 256,741
Operating loss (496,205) (324,202) (186,313)
Interest expense (28,306) (19,414) (16,440)
Loss on extinguishment of debt 0 (24,939) 0
Non-cash interest expense on liabilities related to revenue participation right purchase agreements (29,362) (31,742) (12,892)
Interest and other income, net 27,629 11,342 331
Net loss $ (526,244) $ (388,955) $ (215,314)
Net loss per share - basic $ (5.45) $ (4.33) $ (2.8)
Net loss per share - diluted $ (5.45) $ (4.33) $ (2.8)
Weighted-average number of shares used in computing net loss per share - basic 96,524 89,825 76,886
Weighted-average number of shares used in computing net loss per share - diluted 96,524 89,825 76,886
Other comprehensive gain (loss):      
Unrealized gain (loss) on available-for-sale securities, net $ 3,600 $ (2,721) $ (1,018)
Foreign currency translation adjustments (20) 0 0
Comprehensive loss (522,664) (391,676) (216,332)
Research and Development Revenues [Member]      
Revenues:      
Total revenues 4,030 6,588 10,572
License Revenues [Member]      
Revenues:      
Total revenues 0 0 54,856
Milestone Revenues [Member]      
Revenues:      
Total revenues 3,500 1,000 5,000
Realization of Revenue Participation Right Purchase Agreement [Member]      
Revenues:      
Total revenues $ 0 $ 87,000 $ 0
v3.24.0.1
Consolidated Statements of Stockholders' (Deficit) Equity - USD ($)
$ in Thousands
Total
Common Stock [Member]
Additional Paid-in Capital [Member]
Accumulated Other Comprehensive (Loss) Income [Member]
Accumulated Deficit [Member]
Beginning Balance at Dec. 31, 2020 $ 113,383 $ 70 $ 1,105,470 $ 149 $ (992,306)
Beginning Balance, shares at Dec. 31, 2020   71,015,183      
Exercise of stock options, value 11,020 $ 3 11,017 0 0
Exercise of stock options, shares   1,304,347      
Shares withheld related to net share settlement of equity awards (4,449) $ 0 (4,449) 0 0
Shares withheld related to net share settlement of equity awards, shares   360,050      
Net share settlement (418) $ 0 (418) 0 0
Issuance of common stock upon private placement, value 15,144   15,144 0 0
Issuance of common stock upon private placement, shares   511,182      
Issuance under Employee Stock Purchase Plan, value 1,778 $ 0 1,778 0 0
Issuance under Employee Stock Purchase Plan, shares   108,780      
Issuance of common stock under at-the-market offering/underwritten public offering 296,905 $ 11 296,894 0 0
Issuance of common stock under at-the-market offering/underwritten public offering, shares   11,500,000      
Stock-based compensation 26,832 $ 0 26,832 0 0
Other comprehensive income (loss) (1,018) 0 0 (1,018) 0
Net Income (Loss) (215,314) 0 0 0 (215,314)
Ending Balance at Dec. 31, 2021 243,863 84 1,452,268 (869) (1,207,620)
Ending Balance (ASU 2020-06 [Member]) at Dec. 31, 2021 (38,895) $ 0 (49,476) 0 10,581
Ending Balance, shares at Dec. 31, 2021   84,799,542      
Ending Balance, shares (ASU 2020-06 [Member]) at Dec. 31, 2021   0      
Exercise of stock options, value 14,316 $ 2 14,314 0 0
Exercise of stock options, shares   1,389,031      
Shares withheld related to net share settlement of equity awards (9,602) $ 0 (9,602) 0 0
Shares withheld related to net share settlement of equity awards, shares   (260,172)      
Vesting of restricted stock units, value 0 $ 0 0 0 0
Vesting of restricted stock units, shares   707,772      
Exercise of warrants, value 0 $ 0 0 0 0
Exercise of warrants, share   28,306      
Issuance under Employee Stock Purchase Plan, value 3,227 $ 0 3,227 0 0
Issuance under Employee Stock Purchase Plan, shares   98,153      
Induced conversion of convertible notes (3,378) $ 8 (3,386) 0 0
Induced conversion of convertible notes, shares   8,071,343      
Settlement of capped call on 2026 Notes 26,392 $ 0 26,392 0 0
Stock-based compensation 47,853 0 47,853 0 0
Other comprehensive income (loss) (2,721) 0 0 (2,721) 0
Net Income (Loss) (388,955) 0 0 0 (388,955)
Ending Balance at Dec. 31, 2022 (107,900) $ 94 1,481,590 (3,590) (1,585,994)
Ending Balance, shares at Dec. 31, 2022   94,833,975      
Exercise of stock options, value 14,319 $ 2 14,317 0 0
Exercise of stock options, shares   1,193,325      
Shares withheld related to net share settlement of equity awards (10,517) $ 0 (10,517) 0 0
Shares withheld related to net share settlement of equity awards, shares   (262,829)      
Vesting of restricted stock units, value   $ 1 0 0 0
Vesting of restricted stock units, shares   721,216      
Issuance under Employee Stock Purchase Plan, value 4,140 $ 0 4,140 0 0
Issuance under Employee Stock Purchase Plan, shares   136,065      
Issuance of common stock under at-the-market offering/underwritten public offering 164,233 $ 5 164,228 0 0
Issuance of common stock under at-the-market offering/underwritten public offering, shares   5,016,170      
Stock-based compensation 72,065 $ 0 72,065 0 0
Other comprehensive income (loss) 3,580 0 0 3,580 0
Net Income (Loss) (526,244) 0 0 0 (526,244)
Ending Balance at Dec. 31, 2023 $ (386,323) $ 102 $ 1,725,823 $ (10) $ (2,112,238)
Ending Balance, shares at Dec. 31, 2023   101,637,922      
v3.24.0.1
Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Cash flows from operating activities:      
Net loss $ (526,244) $ (388,955) $ (215,314)
Adjustments to reconcile net loss to net cash used in operating activities:      
Non-cash interest expense on liabilities related to revenue participation right purchase agreement 29,474 31,858 13,004
Stock-based compensation expense 72,065 47,853 26,832
Non-cash lease expense 3,750 2,585 7,361
Impairment of right-of-use assets     2,844
Depreciation of property and equipment 11,892 5,814 2,276
Realized gain on investment, net 35 107  
Interest receivable and amortization on investments (15,735) (4,710) 4,894
Non-cash interest expense related to debt 7,341 5,697 7,125
Loss on extinguishment of debt   2,693  
Loss on inducement of convertible debt   22,246  
Changes in operating assets and liabilities:      
Accounts receivable (1,136) 56,672 (47,399)
Prepaid and other assets 1,596 (7,414) (7,381)
Accounts payable (3,483) 4,524 1,055
Accrued and other liabilities 17,103 10,844 15,060
Deferred revenue   (87,000)  
Operating lease liabilities (1,406) 1,728 43,472
Other non-current liabilities (9,585) (4,058) 3,649
Net cash used in operating activities (414,333) (299,516) (142,522)
Cash flows from investing activities:      
Purchases of investments (635,211) (855,393) (525,042)
Maturities of investments 870,905 604,594 422,837
Sales of investments 4,975   3,300
Purchases of property and equipment (1,416) (11,335) (48,872)
Net cash provided by (used in) investing activities 239,253 (262,134) (147,777)
Cash flows from financing activities:      
Repayment of finance lease liabilities (858) (944)  
Repayment of term loan   (47,651)  
Debt extinguishment costs   (2,409)  
Repayment of convertible debt   (140,330)  
Proceeds from issuance of convertible debt, net   523,586  
Proceeds from public offerings of common stock, net of discounts, commissions and offering cost     296,905
Proceeds from private placement, net     15,144
Proceeds from 2022 RPI Transactions, net 50,000 149,581  
Proceeds from issuance of common stock related to at-the-market offering, net of issuance costs 164,233    
Proceeds from issuance of common stock under equity incentive and stock purchase plans 18,459 17,543 12,380
Taxes paid related to net share settlement of equity awards (10,517) (9,602) (4,449)
Cash Settlement of capped call options associated with 2026 Notes   26,392  
Net cash provided by financing activities 221,317 516,166 319,980
Effect of exchange rate changes (20)    
Net increase (decrease) in cash, cash equivalents, and restricted cash 46,217 (45,484) 29,681
Cash, cash equivalents, and restricted cash, beginning of period 67,182 112,666 82,985
Cash, cash equivalents, and restricted cash, end of period 113,399 67,182 112,666
Supplemental cash flow disclosures:      
Cash paid for interest $ 10,295 15,165 9,175
Right-of-use assets recognized in exchange for operating lease obligations   10,904 80,395
Right-of-use assets recognized in exchange for finance lease obligations   1,055 1,294
Amounts unpaid for purchases of property and equipment   621 $ 11,982
Issuance of common stock in connection with repurchase of convertible note   $ 317,123  
v3.24.0.1
Pay vs Performance Disclosure - USD ($)
$ in Thousands
12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Pay vs Performance Disclosure      
Net Income (Loss) $ (526,244) $ (388,955) $ (215,314)
v3.24.0.1
Insider Trading Arrangements
3 Months Ended
Dec. 31, 2023
Trading Arrangements, by Individual  
Material Terms of Trading Arrangement

During the fourth quarter ended December 31, 2023, none of our directors or officers (as defined in Rule 16a-1(f) under the Exchange Act) adopted or terminated a “Rule 10b5-1 trading arrangement” or “non-Rule 10b5-1 trading arrangement,” as those terms are defined in Item 408 of Regulation S-K.

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
v3.24.0.1
Organization and Accounting Policies
12 Months Ended
Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]  
Organization and Accounting Policies

Note 1 — Organization and Accounting Policies

Organization

Cytokinetics, Incorporated (the “Company”, “we” or “our”) was incorporated under the laws of the state of Delaware on August 5, 1997. We are a late-stage biopharmaceutical company focused on the discovery and development of novel small molecule therapeutics that modulate muscle function for the potential treatment of serious diseases and medical conditions.

Our financial statements contemplate the conduct of our operations in the normal course of business. We have incurred an accumulated deficit of approximately $2.1 billion since inception and there can be no assurance that we will attain profitability. We had a net loss of $526.2 million and net cash used in operations of $414.3 million for the year ended December 31, 2023. Cash, cash equivalents, and investments decreased to $655.4 million as of December 31, 2023 from $829.3 million as of December 31, 2022. We anticipate that we will have operating losses and net cash outflows in future periods.

We are subject to risks common to late-stage biopharmaceutical companies including, but not limited to, development of new drug candidates, dependence on key personnel, and the ability to obtain additional capital as needed to fund our future plans. Our liquidity will be impaired if sufficient additional capital is not available on terms acceptable to us. To date, we have funded operations primarily through sales of our common stock, contract payments under our collaboration agreements, sales of future revenues and royalties, debt financing arrangements, government grants and interest income. Until we achieve profitable operations, we intend to continue to fund operations through payments from strategic collaborations, additional sales of equity securities, grants and debt financings. We have never generated revenues from commercial sales of our drugs and may not have drugs to market for several years, if ever. Our success is dependent on our ability to enter into new strategic collaborations and/or raise additional capital and to successfully develop and market one or more of our drug candidates. We cannot be certain that sufficient funds will be available from such a financing or through a collaborator when required or on satisfactory terms. Additionally, there can be no assurance that our drug candidates will be accepted in the marketplace or that any future products can be developed or manufactured at an acceptable cost. These factors could have a material adverse effect on our future financial results, financial position and cash flows.

Based on the current status of our research and development activities, we believe that our existing cash, cash equivalents, and investments will be sufficient to fund cash requirements for at least the next 12 months after the issuance of these consolidated financial statements. If, at any time, our prospects for financing our research and development programs decline, we may decide to reduce research and development expenses by delaying, discontinuing or reducing our funding of one or more of our research or development programs. Alternatively, we might raise funds through strategic collaborations, public or private financings or other arrangements. Such funding, if needed, may not be available on favorable terms, or at all. The financial statements do not include any adjustments that might result from the outcome of this uncertainty.

Use of Estimates

The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosures of contingent liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting periods. We evaluate our estimates on an ongoing basis. We base our estimates on our historical experience and also on assumptions that we believe are reasonable; however, actual results could significantly differ from those estimates.

Basis of Presentation

The consolidated financial statements include the accounts of Cytokinetics, Incorporated and its wholly-owned subsidiaries and have been prepared in accordance with GAAP. Intercompany transactions and balances have been eliminated in consolidation. Certain prior period amounts have been reclassified to conform the prior period presentation to the current year.

Concentration of Credit Risk and Other Risks and Uncertainties

Financial instruments that potentially subject us to concentrations of risk consist principally of cash, cash equivalents, restricted cash, investments, and accounts receivable.

Our cash, cash equivalents, restricted cash, and investments held with large financial institutions in the United States and deposits may exceed the Federal Deposit Insurance Corporation’s insurance limit.

Drug candidates we develop may require approvals or clearances from the FDA or other regulatory agencies prior to commercial sales. There can be no assurance that our drug candidates will receive any of the required approvals or clearances. If we were to be denied approval, or clearance or any such approval or clearance was to be delayed, it would have a material adverse impact on us.

Cash, Cash Equivalents, and Restricted Cash

We consider all highly liquid investments with a maturity of three months or less at the time of purchase to be cash equivalents, which consist of money market funds and repurchase agreements backed by U.S. Treasury securities. Repurchase agreements are collateralized by US Treasury securities for an amount not less than 102% of their value and are reported at a carrying value which approximates fair value due to their short duration.

A reconciliation of cash, cash equivalents, and restricted cash reported in our consolidated balance sheets to the amount reported within our consolidated statements of cash flows was as follows (in thousands):

 

 

December 31,

 

 

 

2023

 

 

2022

 

Cash and cash equivalents

 

$

113,024

 

 

$

65,582

 

Restricted cash

 

 

375

 

 

 

1,600

 

Total cash, cash equivalents, and restricted cash as reported within our consolidated statement of cash flows

 

$

113,399

 

 

$

67,182

 

As of December 31, 2023, our restricted cash balance of $0.4 million is used to collateralize letters of credit.

Investments

Our investments consist of U.S. Treasury securities, U.S. government agency securities, commercial paper, corporate obligations, and money market funds. We designate all investments as available-for-sale and report them at fair value, based on quoted market prices, with unrealized gains and losses recorded in accumulated other comprehensive loss. The cost of securities sold is based on the specific-identification method. Investments with original maturities greater than three months and remaining maturities of one year or less are classified as short-term investments. Investments with remaining maturities greater than one year are classified as long-term investments.

All of our available-for-sale investments are subject to a periodic impairment review. For each available-for-sale investment whose fair value is below its amortized cost, we determine if the impairment is a result of a credit-related loss or other factors using both quantitative and qualitative factors. If the impairment is a result of a credit-related loss, we recognize an allowance for credit losses. If the impairment is not a result of a credit loss, we recognize the loss in other comprehensive loss.

Property and Equipment, net

Property and equipment are stated at cost less accumulated depreciation and are depreciated on a straight-line basis over the estimated useful lives of the related assets, which are generally three years for computer equipment and software, five years for laboratory equipment and office equipment, and seven years for furniture and fixtures. Amortization of leasehold improvements and finance lease right-of-use assets are computed using the straight-line method over the shorter of the remaining lease term or the estimated useful life of the related assets, typically ranging from three to twelve years. Upon sale or retirement of assets, the costs and related accumulated depreciation and amortization are removed from the balance sheet and the resulting gain or loss is reflected in operations.

Impairment of Long-lived Assets

We review long-lived assets, including property, equipment and right-of-use assets, for impairment whenever events or changes in business circumstances indicate that the carrying amount of the assets may not be fully recoverable. Impairment is measured as the amount by which the carrying amount of a long-lived asset exceeds its fair value. We would recognize an impairment loss when estimated undiscounted future cash flows expected to result from the use of the asset and its eventual disposition are less than its carrying amount.

Leases

We determine if the arrangement contains a lease at inception based on whether the contract conveys the right to control the use of an identified asset. The lease classification is determined at lease commencement, which is the date the underlying asset is available for use by the Company, and preliminary based on whether the arrangement is effectively a financed purchase of the underlying asset (finance lease) or not (operating lease). We determined the lease term at the commencement date by considering whether renewal options and termination options are reasonably assured of exercise. In addition to the fixed minimum lease payments required under the lease arrangements, certain leases include payments of operating expenses that may be revised based on the landlord’s estimate. These variable payments are excluded from the lease payments used to determine the right-of-use asset and lease liability and are recognized when the associated activity occurs.

We recognize right-of-use assets and short-term and long-term lease liabilities on our consolidated balance sheets for operating leases. The right-of-use asset and short-term and long-term lease liabilities for finance leases are recognized in property and equipment, other current liabilities, and other non-current liabilities, respectively, on the consolidated balance sheets.

In determining the present value of lease payments, we estimated our incremental borrowing rate based on information available upon commencement. We base the lease liabilities on the present value of remaining lease payments over the remaining terms of the leases using an estimated rate of interest that we would pay to borrow equivalent funds on a collateralized basis at the lease commencement date. The initial right-of-use asset, for both operating and finance leases, is measured based on the lease liability adjusted for any initial direct costs, lease prepayments, and lease incentives.

We recognize rent expense for operating leases on a straight-line basis over the lease term in operating expenses on the consolidated statements of operations. Finance lease right-of-use assets are amortized on a straight-line basis over the shorter of the expected useful life or the lease term, and the carrying amount of the lease liability is adjusted to reflect interest, which is recorded in interest expense.

We exclude from our consolidated balance sheets recognition of leases having a term of 12 months or less (short-term leases). We account for lease and non-lease components as a single component for our operating leases.

Revenue Recognition

We recognize revenue when we transfer promised goods or services to customers in an amount that reflects the consideration for those goods or services.

At contract inception, we assess the goods or services promised within each contract and assess whether each promised good or service is distinct and determine those that are performance obligations. For example, a license to our intellectual property is determined to be distinct from other performance obligations if licensee is able to use and benefit from the license on its own. Otherwise, licenses are bundled with other promises, such as ongoing research and development services, as combined performance obligation.

We enter into collaborative arrangements with partners that typically include payment to us for one of more of the following: (i) up-front license fees; (ii) milestone payments related to the achievement of developmental, regulatory, or commercial goals; (iii) royalties on net sales of licensed products; and (iv) research and development cost reimbursements. Up-front license fees are included in the transaction price. Development and regulatory milestone payments are included in the transaction price using the most likely amount method, if we conclude it is probable that a significant revenue reversal would not occur. For contracts that include sales-based royalties or sales-based milestones, we recognize revenue at the later of (i) when the related sales occur, or (ii) when the performance obligation to which some or all of the royalty or sales-based milestone has been allocated has been satisfied.

Our joint programs with Astellas under the Astellas OSSA Agreement, and with Amgen under the Amgen Agreement (both of the Astellas OSSA Agreement and the Amgen Agreement having now been terminated), included promises of research and development services. We also entered into the Astellas FSRA Agreement on April 23, 2020. Under the Astellas FSRA Agreement, Astellas agreed to pay one-third of the out-of-pocket clinical development costs which may be incurred in connection with the Company’s Phase 3 clinical trial of reldesemtiv in ALS, up to a maximum contribution by Astellas of $12.0 million. We determined that these services collectively were distinct from any licenses provided to Astellas and Amgen under such agreements, and as such, these services were accounted for as a separate performance obligation recorded over time. We recognized revenue for these services as the performance obligations were satisfied, which we estimated using internal research and development costs incurred.

When a collaborative agreement has more than one performance obligation, we must develop estimates and assumptions that require judgment to determine the underlying stand-alone selling price for each performance obligation which determines how the transaction price is allocated among the performance obligations. The stand-alone selling price may include such items as, forecasted revenues, development timelines, reimbursement rates for personnel costs, discount rates and probabilities of technical and regulatory success, to determine the transaction price to allocate to each performance obligation.

For performance obligations that consist of the delivery of an intellectual property license, the revenue is recognized at the point in time that the license is delivered. For combined performance obligations consisting of an intellectual property license and research and development services, we recognize the combined performance obligation over time, using an input method, as the research and development services are performed.

We are required to make estimates related to the determination of the transaction price and our measurement of how revenue is recognized over time, using the input method. Any changes in these estimates are recorded on a cumulative catch-up basis, which would affect license, collaboration and other revenues and earnings in the period of adjustment.

Accrued Research and Development Expenditures

Clinical trial costs are a component of research and development expense. We accrue and expense clinical trial activities performed by third parties based upon actual work completed in accordance with agreements established with clinical research and manufacturing organizations and clinical sites. We determine the actual costs through monitoring patient enrollment, discussions with internal personnel and external service providers regarding the progress or stage of completion of trials or services and the agreed-upon fee to be paid for such services.

Revenue Participation Right Purchase Agreements

We have entered into certain revenue participation right purchase agreements with certain investors, pursuant to which such investors purchased rights to royalties from certain revenue streams in exchange for consideration. We typically account for such agreements as liabilities to be amortized under the effective interest rate method over the life of the related royalty stream, when we have continuing involvement with the underlying R&D. We typically account for such agreements as deferred income to be amortized under the units-of-revenue method, when there is no continuing involvement with the underlying R&D. We are required to update our estimates, at each reporting period, related to the amount and timing of future royalty payments to be paid to the counterparties of the revenue participation right purchase agreements. The estimates of the future royalty payment determine the measurement of the non-cash interest expense and the carrying value of the liability.

Revenue participation right purchase agreements are measured using significant unobservable inputs. The estimates of future royalties requires the use of several assumptions such as: the probability of clinical success, the probability of regulatory approval, the estimated date of a product launch, estimates of eligible patient populations, estimates of prescribing behavior and patient compliance behavior, estimates of pricing, payor reimbursement and coverage, and sales ramp. As products containing aficamten and omecamtiv mecarbil have not yet been commercialized, the estimates are highly subjective.

In 2020, we entered into a royalty purchase agreement, pursuant to which we sold our right to receive certain payments on the net sales of products containing the compound mavacamten. The consideration received was deferred income to be amortized under the units-of-revenue method, as there was no continuing involvement with the underlying R&D. In 2022, we entered into a tripartite agreement with RTW ICAV and MyoKardia, Inc. acknowledging the release and discharge of any further obligations by us or MyoKardia, Inc. in connection to the Mavacamten Royalty and consequently we recognized the deferred revenue as Realization of revenue participation right purchase agreement on the income statement.

As of December 31, 2023, we have a total carrying value of approximately $380.0 million of liabilities related to revenue participation right purchase agreements.

Research and Development Expenditures

Research and development costs are charged to operations as incurred. Research and development expenses consist primarily of clinical manufacturing costs, preclinical study expenses, consulting and other third-party costs, employee compensation, supplies and materials, allocation of overhead and occupancy costs, facilities costs and depreciation of equipment.

Income Taxes

We account for income taxes under the asset and liability method. Under this method, deferred tax assets and liabilities are determined based on the difference between the financial statement and tax basis of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to affect taxable income. Valuation allowances are established when necessary to reduce deferred tax assets to the amounts expected to be realized.

We recognize uncertain tax positions taken or expected to be taken on a tax return. Tax positions are initially recognized when it is more likely than not that the position will be sustained upon examination by the tax authorities. Such tax positions are initially and subsequently measured as the largest amount of tax benefit that is more likely than not of being realized upon ultimate settlement with the tax authority assuming full knowledge of the position and relevant facts.

We recognize interest accrued related to unrecognized tax benefits and penalties as income tax expense.

Stock-Based Compensation

We maintain equity incentive plans under which incentive stock options may be granted to employees and nonqualified stock options, restricted stock awards, performance-based stock units and stock appreciation rights may be granted to employees, directors, consultants and advisors. In addition, we maintain an ESPP under which employees may purchase shares of our common stock through payroll deductions.

Stock-based compensation expense related to stock options granted to employees and directors is recognized based on the grant date estimated fair values using the Black Scholes option pricing model. The value of the portion of the award that is ultimately expected to vest is recognized as expense ratably over the requisite service period.

Stock-based compensation expense related to performance-based stock units granted to employees is recognized based on the grant-date fair value of each award and recorded as expense over the vesting period using the ratable method when the underlying performance conditions are deemed probable.

Stock-based compensation expense related to the ESPP is recognized based on the fair value of each award estimated on the first day of the offering period using the Black Scholes option pricing model and recorded as expense over the service period using the straight-line method.

v3.24.0.1
Net Loss Per Share
12 Months Ended
Dec. 31, 2023
Earnings Per Share [Abstract]  
Net Loss Per Share

Note 2 — Net Loss Per Share

Basic net loss per share is computed by dividing net loss by the weighted average number of vested common shares outstanding during the period. Diluted net loss per share is computed by giving effect to all potentially dilutive common shares, including outstanding stock options, unvested restricted stock, warrants, convertible preferred stock and shares issuable under our ESPP, during the period using the treasury stock method and convertible notes using the if-converted method.

The following instruments were excluded from the computation of diluted net loss per share for the periods presented because their effect would have been antidilutive (in thousands):

 

 

Years Ended December 31,

 

 

 

2023

 

 

2022

 

 

2021

 

Options to purchase common stock

 

 

11,780

 

 

 

10,992

 

 

 

9,373

 

Warrants to purchase common stock

 

 

13

 

 

 

13

 

 

 

48

 

Restricted stock and performance units

 

 

1,375

 

 

 

1,260

 

 

 

1,415

 

Shares issuable related to the ESPP

 

 

16

 

 

 

13

 

 

 

8

 

Shares issuable upon conversion of 2026 Notes

 

 

2,003

 

 

 

2,003

 

 

 

16,675

 

Shares issuable upon conversion of 2027 Notes

 

 

10,572

 

 

 

10,572

 

 

 

 

Total shares

 

 

25,759

 

 

 

24,853

 

 

 

27,519

 

v3.24.0.1
Research and Development Arrangements
12 Months Ended
Dec. 31, 2023
Research and Development [Abstract]  
Research and Development Arrangements

Note 3 — Research and Development Arrangements

2021 Ji Xing and RTW Transactions

In December 2021, we entered into the 2021 RTW Transactions as described below, related to omecamtiv mecarbil.

Ji Xing Omecamtiv Mecarbil License and Collaboration Agreement

On December 20, 2021, we entered into the Ji Xing OM License Agreement, pursuant to which we granted to Ji Xing an exclusive license to develop and commercialize omecamtiv mecarbil in China and Taiwan. Under the terms of the Ji Xing OM License Agreement, we are the beneficiary of a nonrefundable $50.0 million payment obligation from Ji Xing comprised of a $40.0 million payment as consideration for the rights granted by us to Ji Xing and $10.0 million attributable to our having submitted to the FDA an NDA for omecamtiv mecarbil. The $50.0 million payment was received by the Company in January 2022. We may be eligible to receive from Ji Xing additional payments totaling up to $330.0 million for the achievement of certain commercial milestone events in connection to omecamtiv mecarbil. In addition, Ji Xing will pay us tiered royalties in the mid-teens to the low twenties range on the net sales of pharmaceutical products containing omecamtiv mecarbil in China and Taiwan, subject to certain reductions for generic competition, patent expiration and payments for licenses to third party patents.

Ji Xing will be responsible for the development and commercialization of omecamtiv mecarbil at its own cost and is required to use diligent efforts to develop and commercialize omecamtiv mecarbil in China and Taiwan. The development of omecamtiv mecarbil will be initially focused on HFrEF, and Ji Xing will have the opportunity to participate in Cytokinetics’ global clinical trials of omecamtiv mecarbil. Cytokinetics will supply omecamtiv mecarbil to Ji Xing either as a finished product or as an active pharmaceutical ingredient. Ji Xing may reimburse Cytokinetics for certain costs related to development and supply activities that we perform on their behalf.

The Ji Xing OM License Agreement, unless terminated earlier, will continue on a market-by-market basis until expiration of the relevant royalty term. Ji Xing has the right to terminate the Ji Xing OM License Agreement for convenience. Each party may terminate the Ji Xing OM License Agreement for the other party’s uncured material breach, insolvency, or failure to perform due to extended force majeure events. Cytokinetics may also terminate the Ji Xing OM License Agreement if Ji Xing challenges Cytokinetics’ patents or undergoes certain change of control transactions. Rights granted to Ji Xing in relation to omecamtiv mecarbil will revert to Cytokinetics upon termination, and, under certain circumstances, subject to a low single digit royalty payment by the Company to Ji Xing on the net sales of the products containing the compound omecamtiv mecarbil in China and Taiwan. We assessed this arrangement in accordance with ASC 606 and concluded that there is one performance obligation relating to the license of functional intellectual property. The performance obligation was satisfied, and we recognized the residual allocation of arrangement consideration as revenue of $54.9 million in 2021. Due to the nature of development, including the inherent risk of development and approval by regulatory authorities, we are unable to estimate if and when the development milestone payments could be achieved or become due and, accordingly, we consider the milestone payments to be fully constrained and excluded any potential milestone payments from the initial transaction price.

The consideration related to sales-based milestone payments, including royalties, will be recognized when the related sales occur under the sales- and usage-based royalty exception as these amounts have been determined to relate predominantly to the license.

We re-evaluate the probability of achievement of development milestones and any related constraints each reporting period. We will include consideration, without constraint, in the transaction price to the extent it is probable that a significant reversal in the amount of cumulative revenue recognized will not occur.

Common Stock Purchase Agreements

On December 20, 2021, as part of the 2021 RTW Transactions, we entered into common stock purchase agreements with each of the RTW Investors. These common stock purchase agreements provided for the sale and issuance of an aggregate of 511,182 shares of our common stock at a price per share of $39.125 and an aggregate purchase price of $20.0 million. The closing occurred on December 20, 2021. The RTW Investors have agreed to certain trading and other restrictions with respect to the shares of common stock they purchased pursuant to these agreements, including a restriction on sales or other transfers of the shares, subject to certain exceptions, for a period of one year from the closing date. The restrictions resulted in a premium paid by the RTW Investors of $4.9 million, which represents the excess amount paid over the fair value of the shares of common stock purchased. The premium was determined by analyzing the restrictions discount applied to the closing stock price as of December 20, 2021, which is a Level 2 fair value input. The cash received less the calculated premium is the $15.1 million fair value of the common stock recorded.

2020 Ji Xing and RTW Transactions

On July 14, 2020, we entered in the 2020 RTW Transactions, as described below, with RTW Royalty Holdings and Ji Xing, related to aficamten, our proprietary small molecule cardiac myosin inhibitor product, a novel cardiac myosin inhibitor, and other assets.

Ji Xing Aficamten License and Collaboration Agreement

On July 14, 2020, we entered into the Ji Xing Aficamten License Agreement with Ji Xing, pursuant to which we granted to Ji Xing an exclusive license to develop and commercialize aficamten in China and Taiwan. Under the terms of the Ji Xing Aficamten License Agreement, we received from Ji Xing a nonrefundable upfront payment of $25.0 million. We may be eligible to receive from Ji Xing milestone payments totaling up to $200.0 million for the achievement of certain development and commercial milestone events in connection to aficamten in the field of oHCM and/or nHCM and other indications. In addition, Ji Xing will pay us tiered royalties in the low-to-high teens range on the net sales of the products containing aficamten in China and Taiwan, subject to certain reductions for generic competition, patent expiration and payments for licenses to third party patents.

Ji Xing will be responsible for the development and commercialization of aficamten at its own cost and is required to use diligent efforts to develop and commercialize aficamten in China and Taiwan. The development of aficamten will be initially focused on HCM, and Ji Xing will have the opportunity to participate in Cytokinetics’ global pivotal clinical trials of aficamten. Cytokinetics or a designated supplier will supply aficamten to Ji Xing either as a finished product or as an active pharmaceutical ingredient.

The Ji Xing Aficamten License Agreement, unless terminated earlier, will continue on a market-by-market basis until expiration of the relevant royalty term. Ji Xing has the right to terminate the Ji Xing Aficamten License Agreement for convenience. Each party may terminate the Ji Xing Aficamten License Agreement for the other party’s uncured material breach, insolvency, or failure to perform due to extended force majeure events. Cytokinetics may also terminate the Ji Xing Aficamten License Agreement if Ji Xing challenges Cytokinetics’ patents or undergoes certain change of control transactions. Rights granted to Ji Xing in relation to aficamten will revert to Cytokinetics upon termination, and, under certain circumstances, subject to a low single digit royalty payment by the Company to Ji Xing on the net sales of the products containing the compound aficamten in China and Taiwan.

We assessed this arrangement in accordance with ASC 606 and concluded that there is one performance obligation relating to the license of functional intellectual property. The performance obligation was satisfied, and we recognized the residual allocation of arrangement consideration as revenue of $36.5 million for 2020. Due to the nature of development, including the inherent risk of development and approval by regulatory authorities, we are unable to estimate if and when the development milestone payments could be achieved or become due and, accordingly, we consider the milestone payments to be fully constrained and exclude the milestone payments from the initial transaction price.

The consideration related to sales-based milestone payments, including royalties, will be recognized when the related sales occur under the sales and usage-based royalty exception of ASC 606 as these amounts have been determined to relate predominantly to the license.

We re-evaluate the probability of achievement of development milestones and any related constraints each reporting period. We will include consideration, without constraint, in the transaction price to the extent it is probable that a significant reversal in the amount of cumulative revenue recognized will not occur.

We recognized a $2.5 million milestone from Ji Xing in 2023 for the initiation of a phase 3 clinical trial for aficamten in nHCM which was collected in the fourth quarter of 2023.

We recognized a $5.0 million milestone from Ji Xing during the third quarter of 2021 for initiation of a phase 3 clinical trial for aficamten in oHCM. Although our contractual right to payment had not arisen under the Ji Xing Aficamten License Agreement, we determined recognition of the milestone in 2021 was appropriate based on our expected initiation of a phase 3 clinical trial of aficamten in oHCM and was recorded as a corresponding contract asset in other current assets in our consolidated balance sheet as of December 31, 2021.

Research and development revenue from Ji Xing for 2023 and 2022 was $1.3 million and $0.9 million, respectively, related to certain development cost reimbursements. We had no research and development revenue from Ji Xing in 2021.

We had accounts receivable from Ji Xing of $0.3 million as of December 31, 2023 and $0.1 million as of December 31, 2022.

Royalty Purchase Agreement

On July 14, 2020, we entered the RTW Royalty Purchase Agreement with RTW Royalty Holdings, pursuant to which we sold our Mavacamten Royalty, under the Research Collaboration Agreement, dated August 24, 2012, between us and MyoKardia, Inc. to RTW Royalty Holdings for a one-time payment of $85.0 million. The RTW Royalty Purchase Agreement transaction closed on November 13, 2020. On March 31, 2021, RTW Royalty Holdings assigned its rights and obligations under the RTW Royalty Purchase Agreement to its affiliate, RTW ICAV. We understand that on April 18, 2022, RTW ICAV and MyoKardia, Inc. entered into agreements, which purported to assign all of RTW ICAV's rights, title and interest to the Mavacamten Royalty to MyoKardia, Inc., and on April 25, 2022, we entered into a tripartite agreement with RTW ICAV and MyoKardia, Inc. acknowledging the release and discharge of any further obligations by us or MyoKardia, Inc. in connection to the Mavacamten Royalty.

The allocation of the consideration for the 2020 RTW Transactions resulted in $87.0 million being allocated to the RTW Royalty Purchase Agreement representing its fair value. The $87.0 million was initially recorded as deferred revenue. On April 25, 2022, as discussed above, we entered into a tripartite agreement with RTW ICAV and MyoKardia, Inc. acknowledging the release and discharge of any further obligations by us or MyoKardia, Inc. in connection to the Mavacamten Royalty. As a result of the full extinguishment of the Mavacamten Royalty, we recognized revenue of $87.0 million in 2022.

Astellas

Our strategic alliance with Astellas to advance novel therapies for diseases and medical conditions associated with skeletal muscle impairment and weakness commenced in 2013 under the Astellas Agreement.

On April 23, 2020, we and Astellas entered into the two agreements referenced below which, taken together, amend and restate the Company’s research, development and commercialization collaboration with Astellas under the Astellas Agreement.

Fast Skeletal Regulatory Activator Agreement

The Company and Astellas entered into the Astellas FSRA Agreement on April 23, 2020. As a result of the Astellas FSRA Agreement, the Company will now have exclusive control and responsibility for the Company's future development and commercialization of reldesemtiv, CK-601 and other FSRA compounds and products, and accordingly, Astellas has agreed to terminate its license to all FSRA compounds and related products.

Under the Astellas FSRA Agreement, Astellas agreed to pay one-third of the out-of-pocket clinical development costs which may be incurred in connection with the Company’s Phase 3 clinical trial of reldesemtiv in ALS, up to a maximum contribution by Astellas of $12 million. Astellas also agreed to non-cash contributions to the Company, which included the transfer of its existing inventories of active pharmaceutical ingredient of reldesemtiv and CK-601. As of December 31, 2023, we have billed and collected from Astellas up to the maximum contribution of $12.0 million. On March 31, 2023, we announced that we discontinued COURAGE-ALS, our Phase 3 clinical trial of reldesemtiv in patients with ALS, and COURAGE-ALS OLE.

Research and development revenue from Astellas for 2023, 2022, and 2021 was $2.7 million, $5.7 million, and $3.2 million, respectively.

We had no accounts receivable from Astellas as of December 31, 2023 and 2022.

Amgen

On November 23, 2020, we received written notice of termination from Amgen of the Amgen Agreement pertaining to the discovery, development and commercialization of novel small molecule therapeutics, including omecamtiv mecarbil, a novel cardiac myosin activator, and CK-136 (formerly AMG 594), a novel cardiac troponin activator. The termination of the Amgen Agreement was effective May 20, 2021.

We recognized research and development revenue for reimbursements from Amgen of both internal costs of certain full-time employee equivalents and other costs related to the Amgen Agreement, which terminated effective May 20, 2021. Research and development revenue from Amgen was $7.4 million in 2021 and consisted of reimbursement of costs we incurred related to METEORIC-HF. There was no research and development revenue from Amgen in 2023 and 2022.

v3.24.0.1
Fair Value Measurements
12 Months Ended
Dec. 31, 2023
Fair Value Disclosures [Abstract]  
Fair Value Measurements

Note 4 — Fair Value Measurements

We value our financial assets and liabilities at fair value, defined as the price that would be received for assets when sold or paid to transfer a liability in an orderly transaction between market participants at the measurement date (exit price). We utilize market data or assumptions that we believe market participants would use in pricing the asset or liability, including assumptions about risk and the risks inherent in the inputs to the valuation technique. These inputs can be readily observable, market corroborated or generally unobservable.

We primarily apply the market approach for recurring fair value measurements and endeavor to utilize the best information reasonably available. Accordingly, we use valuation techniques that maximize the use of observable inputs and minimize the use of unobservable inputs to the extent possible and consider the security issuers’ and the third-party issuers’ credit risk in our assessment of fair value.

We classify fair value based on the observability of those inputs using a hierarchy that prioritizes the inputs used to measure fair value. The hierarchy gives the highest priority to unadjusted quoted prices in active markets for identical assets or liabilities (Level 1 measurement) and the lowest priority to unobservable inputs (Level 3 measurement):

Level 1 — Observable inputs, such as quoted prices in active markets for identical assets or liabilities;

Level 2 — Inputs, other than the quoted prices in active markets, that are observable either directly or through corroboration with observable market data; and

Level 3 — Unobservable inputs, for which there is little or no market data for the assets or liabilities, such as internally-developed valuation models.

Fair Value of Financial Assets

The follow tables set forth the fair value of our financial assets, which consists of cash equivalents and investments classified as available-for-sale securities, that were measured on a recurring basis (in thousands):

 

 

December 31, 2023

 

 

 

Fair Value Hierarchy Level

 

Amortized
Cost

 

 

Unrealized
Gains

 

 

Unrealized
Losses

 

 

Fair
Value

 

Money market funds

 

Level 1

 

$

77,429

 

 

$

 

 

$

 

 

$

77,429

 

U.S. Treasury securities

 

Level 1

 

 

34,625

 

 

 

13

 

 

 

(15

)

 

 

34,623

 

U.S. Government agency securities

 

Level 2

 

 

175,301

 

 

 

87

 

 

 

(133

)

 

 

175,255

 

Commercial paper

 

Level 2

 

 

252,956

 

 

 

156

 

 

 

(59

)

 

 

253,053

 

Corporate obligations

 

Level 2

 

 

92,384

 

 

 

103

 

 

 

(142

)

 

 

92,345

 

 

 

 

 

$

632,695

 

 

$

359

 

 

$

(349

)

 

$

632,705

 

 

 

 

December 31, 2022

 

 

 

Fair Value Hierarchy Level

 

Amortized
Cost

 

 

Unrealized
Gains

 

 

Unrealized
Losses

 

 

Fair
Value

 

Money market funds

 

Level 1

 

$

45,887

 

 

$

 

 

$

 

 

$

45,887

 

U.S. Treasury securities

 

Level 1

 

 

172,568

 

 

 

 

 

 

(1,102

)

 

 

171,466

 

U.S. Treasury securities backed repurchase agreements

 

Level 2

 

 

16,003

 

 

 

 

 

 

 

 

 

16,003

 

U.S. Government agency securities

 

Level 2

 

 

129,174

 

 

 

12

 

 

 

(820

)

 

 

128,366

 

Foreign government agency securities

 

Level 2

 

 

7,599

 

 

 

 

 

 

(69

)

 

 

7,530

 

Commercial paper

 

Level 2

 

 

329,359

 

 

 

28

 

 

 

(431

)

 

 

328,956

 

Corporate obligations

 

Level 2

 

 

128,594

 

 

 

 

 

 

(1,209

)

 

 

127,385

 

 

 

 

 

$

829,184

 

 

$

40

 

 

$

(3,631

)

 

$

825,593

 

No credit losses on debt securities were recognized in 2023 or 2022. In its evaluation to determine expected credit losses, management considered all available historical and current information, expectations of future economic conditions, the type of security, the credit rating of the security, and the size of the loss position, as well as other relevant information. The Company does not intend to sell, and is unlikely to be required to sell, any of these available-for-sale investments before their effective maturity or market price recovery.

v3.24.0.1
Balance Sheet Components
12 Months Ended
Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]  
Balance Sheet Components

Note 5 — Balance Sheet Components

Our property and equipment consisted of (in thousands):

 

 

December 31,

 

 

 

2023

 

 

2022

 

Property and equipment, net:

 

 

 

 

 

 

Laboratory equipment

 

$

18,839

 

 

$

18,490

 

Computer equipment and software

 

 

3,263

 

 

 

3,900

 

Office equipment, furniture and fixtures

 

 

6,061

 

 

 

6,056

 

Leasehold improvements

 

 

66,874

 

 

 

65,912

 

Construction in progress

 

 

220

 

 

 

741

 

Right-of-use assets, finance lease

 

 

1,839

 

 

 

2,448

 

Total property and equipment

 

 

97,096

 

 

 

97,547

 

Less: Accumulated depreciation

 

 

(28,348

)

 

 

(17,094

)

 

 

$

68,748

 

 

$

80,453

 

Depreciation expense was $11.9 million, $5.8 million, and $2.3 million for 2023, 2022, and 2021, respectively.

Our accrued liabilities were as follows (in thousands):

 

 

December 31,

 

 

 

2023

 

 

2022

 

Accrued liabilities:

 

 

 

 

 

 

Clinical and preclinical costs

 

$

5,880

 

 

$

16,105

 

Compensation related

 

 

29,255

 

 

 

21,767

 

Other accrued expenses

 

 

7,506

 

 

 

6,224

 

Total accrued liabilities

 

$

42,641

 

 

$

44,096

 

We sponsor a 401(k) defined contribution plan covering all employees and contributed $2.5 million, $1.8 million, and $1.1 million to this plan in 2023, 2022, and 2021, respectively.

v3.24.0.1
Agreements with Royalty Pharma
12 Months Ended
Dec. 31, 2023
Agreements with Royalty Pharma [Abstract]  
Agreements with Royalty Pharma Note 6 — Agreements with Royalty Pharma

On January 7, 2022, we announced that we had entered into the 2022 RPI Transactions with affiliates of Royalty Pharma International plc.

The RP Loan Agreement and the RP Aficamten RPA described below, are determined to be debt instruments subsequently measured at amortized cost and were entered into with parties that were at the time of our entry into the 2022 RPI Transactions affiliated and in contemplation of one another. We used the relative fair value method and made separate estimates of the fair value of each freestanding financial instrument and then allocated the proceeds in proportion to those fair value amounts. Arrangement consideration for the RP Loan Agreement and the RP Aficamten RPA totaled $150 million, consisting of the two $50 million upfront payments for the signing of the RP Loan Agreement and the RP Aficamten RPA and milestone of $50 million for initiation of the first pivotal trial in oHCM for aficamten that was deemed probable at the signing of the agreements.

The initial consideration was allocated as follows (in thousands):

 

 

Fair Value

 

 

Proceeds

 

 

Allocation

 

Units of Accounting:

 

 

 

 

 

 

 

 

 

Revenue Participation Right Purchase Agreement

 

$

69,498

 

 

$

100,000

 

 

$

89,571

 

Development Funding Loan Agreement

 

 

46,887

 

 

 

50,000

 

 

 

60,429

 

Total consideration

 

$

116,385

 

 

$

150,000

 

 

$

150,000

 

 

2022 RP Loan Agreement

Under the RP Loan Agreement, we were initially entitled to receive up to $300.0 million in term loans, $50.0 million of which was disbursed to us on closing and the remaining $250.0 million scheduled to have been available to us upon our satisfaction of customary disbursement conditions and certain development conditions by specific deadlines, as follows:

$50.0 million of tranche 2 term loans during the one year period following the receipt on or prior to March 31, 2023 of marketing approval from FDA of omecamtiv mecarbil;
$25.0 million of tranche 3 term loans during the one year period following the commercial availability of a diagnostic test measuring levels of omecamtiv mecarbil to support the final FDA label language applicable to such drug, subject to such commercial availability and the conditions to the tranche 2 term loans having occurred on or prior to March 31, 2023;
$75.0 million of tranche 4 term loans during the one year period following the receipt on or prior to September 30, 2024 of positive results from SEQUOIA-HCM, the Phase 3 trial for aficamten; and
$100.0 million of tranche 5 term loans during the one year period following the acceptance by the FDA on or prior to March 31, 2025 of an NDA for aficamten, subject to the conditions to the tranche 4 term loans having occurred on or prior to September 30, 2024.

As a result of our receipt of a CRL on February 28, 2023, in connection to our NDA for omecamtiv mecarbil, we have not satisfied the conditions to the availability of the tranche 2 and tranche 3 loans under the RP Loan Agreement.

In December 2023, we announced positive topline results from SEQUOIA-HCM, the Phase 3 trial for aficamten. This entitled us to receive $75.0 million under tranche 4 during the one year period following the receipt of the positive results and requires us to complete a minimum mandatory draw of at least $50.0 million of the $75.0 million available.

The remaining $100.0 million under tranche 5 remains available for disbursement to us, subject to satisfaction of the conditions described above.

Each term loan under the RP Loan Agreement matures on the 10 year anniversary of the funding date for such term loan and is repayable in quarterly installments of principal, interest and fees commencing on the last business day of the seventh full calendar quarter following the calendar quarter of the applicable funding date for such term loan, with the aggregate amount payable in respect of each term loan (including interest and other applicable fees) equal to 190% of the principal amount of the term loan for the tranche 1, tranche 4 and tranche 5 term loans and 200% of the principal amount of the term loan for tranche 2 and tranche 3 term loans (such amount with respect to each term loan, “Final Payment Amount”). We accounted for amounts initially drawn under the RP Loan Agreement using the effective interest method which resulted in an effective interest rate of 7.65% over the ten-year term. As of the date of the prepayment or maturity of the term loan (or the date such prepayment or repayment is required to be paid), we will be required to pay an additional amount equal to $34.6 million accreted over the term of the loan. We have made our first payment in the fourth quarter of 2023.

We may prepay the term loans in full (but not in part) at any time at our option by paying an amount equal to the unpaid portion of Final Payment Amount for the outstanding term loans under the RP Loan Agreement; provided that if the conditions for either the tranche 4 term loans or the tranche 5 term loans have been met, we must have borrowed at least $50 million principal amount of the tranche 4 or 5 term loans. In addition, the term loans under the RP Loan Agreement are repayable in full at the option of either us or the lender in an amount equal to the unpaid portion of Final Payment Amount for the outstanding term loans upon a change of control of Cytokinetics.

Future minimum payments under the existing borrowing under RP Loan Agreement are (in thousands):

Years ending December 31:

 

 

 

2024

 

$

10,080

 

2025

 

 

11,520

 

2026

 

 

11,520

 

2027

 

 

11,520

 

2028

 

 

11,520

 

Thereafter

 

 

37,440

 

Future minimum payments

 

 

93,600

 

Less: Unamortized interest and loan costs

 

 

(25,136

)

Term Loan, net

 

$

68,464

 

As of December 31, 2023, the estimated fair value of our RP Loan Agreement was $59.9 million. The fair value was estimated based on Level 3 inputs.

Concurrent with our entry into the RP Loan Agreement discussed above, we terminated the Term Loan Agreement with Silicon Valley Bank and Oxford Finance LLC and repaid all amounts outstanding thereunder as further described in Note 7.

2022 RP Aficamten Royalty Purchase Agreement

In addition, on January 7, 2022, we entered into the RP Aficamten RPA with RPI ICAV, pursuant to which RPI ICAV purchased rights to certain revenue streams from net sales of pharmaceutical products containing aficamten by us, our affiliates and our licensees in exchange for up to $150.0 million in consideration, $50.0 million of which was paid on the closing date, $50.0 million of which was paid to us in March 2022 following the initiation of the first pivotal trial in oHCM for aficamten, and $50.0 million of which was paid to us in September 2023 following the initiation of the first pivotal clinical trial in nHCM for aficamten. The RP Aficamten RPA also provides that the parties will negotiate terms for additional funding if we achieve proof of concept results in certain other indications for aficamten, with a reduction in the applicable royalty if we and RPI ICAV fail to agree on such terms in certain circumstances.

Pursuant to the RP Aficamten RPA, RPI ICAV purchased the right to receive a percentage of net sales equal to 4.5% for annual worldwide net sales of pharmaceutical products containing aficamten up to $1 billion and 3.5% for annual worldwide net sales of pharmaceutical products containing aficamten in excess of $1 billion, subject to reduction in certain circumstances. Our liability to RPI ICAV is referred to as the “RP Aficamten Liability”.

We account for the RP Aficamten Liability as a liability primarily because we have significant continuing involvement in generating the related revenue stream from which the liability will be repaid. If and when aficamten is commercialized and royalties become due, we will recognize the portion of royalties paid to RPI ICAV as a decrease to the RP Aficamten Liability and a corresponding reduction in cash.

The carrying amount of the RP Aficamten Liability is based on our estimate of the future royalties to be paid to RPI ICAV over the life of the arrangement as discounted using an imputed rate of interest. The imputed rate of interest on the carrying value of the RP Aficamten Liability was approximately 24.8% as of December 31, 2023 and 22.4% as of December 31, 2022.

In 2023, we updated our analyses of the RP Aficamten RPA to reflect our assumptions resulting from ongoing global market research and to reflect other adjustments in connection with our anticipated commercialization, including the additional consideration of $50.0 million which was paid to us in September 2023 following the initiation of the first pivotal clinical trial in nHCM for aficamten. Our estimates regarding the amount of future royalty payments under the RP Aficamten RPA changed from the fourth quarter of 2022 due to changes in management’s estimates of unobservable inputs related to market conditions and timing to include projections of future royalty payments. The resulting probability-adjusted sales forecast for aficamten has increased year over year mainly due to the receipt of positive topline results from SEQUOIA-HCM, the Phase 3 trial for aficamten, in December 2023.

The change in estimates are accounted for on a prospective basis in our liability calculation and resulted in changes in our imputed interest rate and non-cash interest expense from 22.4% and $5.2 million in the fourth quarter of 2022, 22.4% and $5.4 million in the first quarter of 2023, 19.0% and $4.9 million in the second quarter of 2023, 18.0% and $5.4 million in the third quarter of 2023, to 24.8% and $9.8 million in the fourth quarter of 2023. The non-cash interest expense was $25.5 million and $15.5 million in 2023 and 2022, respectively. In 2023, the change in estimate increased our non-cash interest expense and net loss by $2.0 million. The change in accounting estimate increased the net loss per share by $0.02 in 2023.

2017 RP Omecamtiv Mecarbil Royalty Purchase Agreement

In February 2017, we entered into the RP OM RPA pursuant to which we sold a portion of our right to receive royalties from Amgen on future net sales of omecamtiv mecarbil to RPFT for a one-time payment of $90 million, which is non-refundable even if omecamtiv mecarbil is never commercialized. Concurrently, we entered into a common stock purchase agreement with RPFT through which RPFT purchased 875,656 shares of the Company’s common stock for $10.0 million. We allocated the consideration and issuance costs on a relative fair value basis to our liability to RPFT related to sale of future royalties under the RP OM RPA (the “RP OM Liability”) and the common stock sold to RPFT, which resulted in the RP OM Liability being initially recognized at $92.3 million. The RP OM RPA provides for the sale of a royalty to RPFT of 4.5% on worldwide net sales of omecamtiv mecarbil, subject to a potential increase of up to an additional 1% under certain circumstances. As a result of our receipt of a CRL on February 28, 2023 in connection to our NDA for omecamtiv mecarbil, pursuant to the terms of the RP OM RPA, the applicable royalty rate will increase to a maximum of 5.5% if omecamtiv approval obtains FDA approval at any time after June 30, 2023.

As a result of the termination of the Amgen Agreement and pursuant to our obligations under the RP OM RPA, we and RPFT amended the RP OM RPA on January 7, 2022 to preserve RPFT’s rights under the RP OM RPA by providing for direct payments by us to RPFT of up to 5.5% of our and our affiliates and licensees worldwide net sales of omecamtiv mecarbil. The RP OM RPA, as amended, had no impact on the original accounting for the $92.3 million associated with the RP OM Liability established in February 2017.

We account for the RP OM Liability as a liability primarily because we have significant continuing involvement in generating the related revenue stream from which the liability will be repaid. If and when omecamtiv mecarbil is commercialized and royalties become due, we will recognize the portion of royalties paid to RPFT as a decrease to the RP OM Liability and a corresponding reduction in cash.

The carrying amount of the RP OM Liability is based on our estimate of the future royalties to be paid to RPFT over the life of the arrangement as discounted using an imputed rate of interest. The excess of future estimated royalty payments over the $92.3 million of allocated proceeds, less issuance costs, is recognized as non-cash interest expense using the effective interest method. The imputed rate of interest on the carring value of the RP OM Liability was approximately 0.1% as of December 31, 2023 and 8.5% as of December 31, 2022.

In 2023, we updated our analyses of the RP OM RPA to reflect our current assumptions resulting from ongoing global market research and to reflect other adjustments in connection with our anticipated commercialization, including the result of our receipt of a CRL in connection to our NDA for omecamtiv mecarbil. As a consequence of our receipt of the CRL from FDA, the royalty rate under the RP OM RPA will increase to no more than 5.5%. The resulting probability-adjusted sales forecast for omecamtiv mecarbil has decreased year over year because commercialization and sales of omecamtiv mecarbil will be delayed.

Changes in estimates are accounted for on a prospective basis in our liability calculation and resulted in changes in our imputed interest rate and non-cash interest expense from 8.5% and $4.0 million in the fourth quarter of 2022, 1.9% and $0.9 million in the first quarter of 2023, 2.9% and $1.4 million in the second and third quarter of 2023, and to 0.1% and $0.1 million in the fourth quarter of 2023, respectively. The non-cash interest expense was $3.9 million, $16.2 million, and $12.9 million in 2023, 2022, and 2021, respectively. In 2023, the change in estimate decreased our non-cash interest expense and net loss by $12.8 million. The change in accounting estimate reduced the net loss per share by $0.13 in 2023.

Accounting for the Royalty Pharma Royalty Purchase Agreements

We periodically assess the amount and timing of expected royalty payments using a combination of internal projections and forecasts from external sources. To the extent such payments are greater or less than our initial estimates or the timing of such payments is materially different than its original estimates, we will prospectively adjust the amortization of the RP OM Liability and the RP Aficamten Liability and the effective interest rate.

There are a number of factors that could materially affect the amount and timing of royalty payments, a number of which are not within our control. The RP OM Liability and the RP Aficamten Liability are recognized using significant unobservable inputs. The estimates of future royalties requires the use of several assumptions such as: the probability of clinical success, the probability of regulatory approval, the estimated date of a product launch, estimates of eligible patient populations, estimates of prescribing behavior and patient compliance behavior, estimates of pricing, payor reimbursement and coverage, and sales ramp. A significant change in unobservable inputs could result in a material increase or decrease to the effective interest rate of the RP OM Liability and the RP Aficamten Liability.

We recorded $50.0 million of additional consideration associated with the 2022 RP Aficamten Royalty Purchase Agreement upon receipt of the cash in the third quarter of 2023.

We review our assumptions on a regular basis and our estimates may change in the future as we refine and reassess our assumptions.

Changes to the RP Aficamten Liability and the RP OM Liability are as follows (in thousands):

 

 

RP Aficamten Liability

 

 

RP OM Liability

 

 

 

2023

 

 

2022

 

 

2023

 

 

2022

 

 

2021

 

 Beginning balance, January 1

 

$

105,117

 

 

$

 

 

$

195,384

 

 

$

179,072

 

 

$

166,068

 

 Initial carrying value

 

 

 

 

 

89,571

 

 

 

 

 

 

 

 

 

 

 Additional consideration

 

 

50,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 Interest accretion

 

 

25,474

 

 

 

15,546

 

 

 

3,888

 

 

 

16,196

 

 

 

12,892

 

 Amortization of issuance costs

 

 

 

 

 

 

 

 

112

 

 

 

116

 

 

 

112

 

 Ending balance, December 31

 

$

180,591

 

 

$

105,117

 

 

$

199,384

 

 

$

195,384

 

 

$

179,072

 

v3.24.0.1
Debt
12 Months Ended
Dec. 31, 2023
Debt Disclosure [Abstract]  
Debt

Note 7 — Debt

Silicon Valley Bank and Oxford Finance Term Loans

Prior to January 7, 2022, we maintained $45.0 million aggregate principal amount of the Term Loan Agreement with Silicon Valley Bank and Oxford Finance LLC.

The Term Loan Agreement was terminated, and all amounts thereunder repaid in connection to our entry into that certain RP Loan Agreement, between us and RPDF, as further described above.

As a result of the termination of the Term Loan Agreement and the repayment to the Lenders, in 2022, we recorded $2.7 million in loss on debt extinguishment in the consolidated statements of operations and comprehensive loss, consisting of the premium on debt repayments and the write-off of the remaining term loan fees and debt issuance costs.

Interest expense for the Term Loan Agreement was immaterial for 2022 because it represented approximately one week of interest before extinguishment. Interest expense for the Term Loan Agreement was $4.8 million for 2021.

Convertible Notes

On November 13, 2019, we issued $138.0 million aggregate principal amount of 2026 Notes. On July 6, 2022, we issued $540.0 million aggregate principal amount of 2027 Notes and used approximately $140.3 million of the net proceeds from the offering of 2027 Notes and issued 8,071,343 shares of common stock to repurchase approximately $116.9 million aggregate principal amount of the 2026 Notes pursuant to privately negotiated exchange agreements entered into with certain holders of the 2026 Notes concurrently with the pricing of the offering of the 2027 Notes. As a result of the partial repurchase of the 2026 Notes, the Company recorded an inducement loss of $22.2 million, consisting of the difference between the consideration to the holders pursuant to the exchange agreements and the if-converted value of the 2026 Notes under the original terms. As of December 31, 2023, there remain $21.1 million aggregate principal amount of 2026 Notes outstanding.

The 2026 Notes are unsecured obligations and bear interest at an annual rate of 4.0% per year, payable semi-annually on May 15 and December 15 of each year, beginning May 15, 2020. The 2026 Notes are governed by an indenture we entered into with U.S. Bank National Association, as trustee. The 2026 Notes will mature on November 15, 2026, unless earlier repurchased or redeemed by us or converted at the option of the holders. We may redeem the 2026 Notes prior to the maturity date but we are not required to and no sinking fund is provided for the 2026 Notes. The 2026 Notes may be converted, under certain circumstances as described below, based on an initial conversion rate of 94.7811 shares of common stock per $1,000 principal amount (which represents an initial conversion price of $10.55 per share). The conversion rate for the 2026 Notes will be subject to adjustment upon the occurrence of certain specified events. In addition, upon the occurrence of a make-whole fundamental change (as defined in the indenture), we will, in certain circumstances, increase the conversion rate by a number of additional shares for a holder that elects to convert its notes in connection with such make-whole fundamental change. The 2026 Notes are convertible at December 31, 2023 at the option of the holder.

The 2026 Notes will be redeemable, in whole or in part, at our option at any time, and from time to time, on or after November 20, 2023 and, in the case of any partial redemption, on or before the 60th scheduled trading day before the maturity date, at a cash redemption price equal to the principal amount of the 2026 Notes to be redeemed, plus accrued and unpaid interest, if any, to, but excluding, the redemption date but only if the last reported sale price per share of our common stock exceeds 130% of the conversion price on (1) each of at least 20 trading days, whether or not consecutive, during the 30 consecutive trading days ending on, and including, the trading day immediately before the date we may send the related redemption notice; and (2) the trading day immediately before the date we may send such notice. If a “fundamental change” (as defined in the indenture agreement, dated November 13, 2019 between us and U.S. Bank National Association, as trustee, as supplemented by the first supplemental indenture dated as of November 13, 2019 between us and such trustee) occurs, then, subject to certain exceptions, holders may require us to repurchase their 2026 Notes at a cash repurchase price equal to the principal amount of the 2026 Notes to be repurchased, plus accrued and unpaid interest, if any, to, but excluding, the fundamental change repurchase date.

The following table presents the total amount of interest cost recognized relating to the 2026 Notes (in thousands):

 

 

Years Ended December 31,

 

 

 

2023

 

 

2022

 

 

2021

 

Contractual interest expense

 

$

844

 

 

$

3,265

 

 

$

5,520

 

Accretion of debt discount

 

 

 

 

 

 

 

 

5,907

 

Amortization of debt issuance costs

 

 

108

 

 

 

355

 

 

 

59

 

Total interest expense recognized

 

$

952

 

 

$

3,620

 

 

$

11,486

 

The effective interest rate of the 2026 Notes was 4.6% as of December 31, 2023 and 2022 and 12.5% as of December 31, 2021. As of December 31, 2023. the unamortized debt issuance cost for the 2026 Notes was $0.3 million and will be amortized over approximately 2.9 years.

The 2027 Notes ($540.0 million of aggregate principal) are our senior, unsecured obligations and are (i) senior in right of payment to our future indebtedness that is expressly subordinated to the 2027 Notes in right of payment; (ii) equal in right of payment with all of our indebtedness that is not so subordinated (including the 2026 Notes); (iii) effectively subordinated to our existing and future secured indebtedness, to the extent of the value of the collateral securing that indebtedness; and (iv) structurally subordinated to all existing and future indebtedness and other liabilities, including trade payables, and (to the extent we are not a holder thereof) preferred equity, if any, of our subsidiaries. The net proceeds of the 2027 Notes were approximately $523.6 million after deducting issuance costs related to the 2027 Notes. The 2027 Notes bear interest at a rate of 3.5% per year, payable semiannually in arrears on January 1 and July 1 of each year, beginning on January 1, 2023. The 2027 Notes will mature on July 1, 2027, unless earlier converted, redeemed or repurchased.

The 2027 Notes are convertible into cash, shares of our common stock or a combination of cash and shares of our common stock, at our election, based on the applicable conversion rate(s). The initial conversion rate for the 2027 Notes is 19.5783 shares of our common stock per $1,000 principal amount of such Notes, which is equivalent to an initial conversion price of approximately $51.08 per share. Holders of the 2027 Notes may convert all or any portion of their convertible notes at their option only in the following circumstances: (i) during any calendar quarter (and only during such calendar quarter) commencing after the calendar quarter ending on September 30, 2022, if the last reported sale price per share of our common stock, $0.001 par value per share, exceeds 130% of the conversion price for each of at least 20 trading days, whether or not consecutive, during the 30 consecutive trading days ending on, and including, the last trading day of the immediately preceding calendar quarter; (ii) during the five consecutive business days immediately after any 10 consecutive trading day period (such 10 consecutive trading day period, the “measurement period”) if the trading price per $1,000 principal amount of 2027 Notes for each trading day of the measurement period was less than 98% of the product of the last reported sale price per share of our common stock on such trading day and the conversion rate on such trading day; (iii) upon the occurrence of certain corporate events or distributions on our common stock, as described in the 2027 Indenture; (iv) if we call such 2027 Notes for redemption; and (v) at any time from, and including, March 1, 2027 until the close of business on the scheduled trading day immediately before the maturity date.

We may not redeem the 2027 Notes at our option at any time before July 7, 2025. The 2027 Notes will be redeemable, in whole or in part (subject to the “Partial Redemption Limitation” (as defined in the 2027 Indenture)), at our option at any time, and from time to time, on or after July 7, 2025 and, in the case of a partial redemption, on or before the 60th scheduled trading day immediately before the maturity date, at a cash redemption price equal to the principal amount of the 2027 Notes to be redeemed, plus accrued and unpaid interest, if any, to, but excluding, the redemption date, but only if the last reported sale price per share of our common stock exceeds 130% of the conversion price on (i) each of at least 20 trading days, whether or not consecutive, during the 30 consecutive trading days ending on, and including, the trading day immediately before the date we may send the related redemption notice; and (ii) the trading day immediately before the date we may send such notice. In addition, calling any of the 2027 Notes for redemption will constitute a Make-Whole Fundamental Change with respect to that convertible note, in which case the conversion rate applicable to the conversion of that Note will be increased in certain circumstances if it is converted after it is called for redemption. The conversion rate for the 2027 Notes shall not exceed 25.4517 shares per $1,000 principal amount of such Notes, subject to certain customary anti-dilution adjustments (as defined in the 2027 indenture). Pursuant to the Partial Redemption Limitation, we may not elect to redeem less than all of the outstanding 2027 Notes unless at least $75.0 million aggregate principal amount of 2027 Notes are outstanding and not subject to redemption as of the time we may send the related redemption notice.

If a “Fundamental Change” (as defined in the 2027 Indenture) occurs, then, subject to a limited exception for certain cash mergers, noteholders may require us to repurchase their 2027 Notes at a cash repurchase price equal to the principal amount of the 2027 Notes to be repurchased, plus accrued and unpaid interest, if any, to, but excluding, the fundamental change repurchase date. The definition of Fundamental Change includes certain business combination transactions involving us and certain de-listing events with respect to our common stock.

The following table presents the total amount of interest cost recognized relating to the 2027 Notes (in thousands):

 

 

2023

 

 

2022

 

Contractual interest expense

 

$

18,900

 

 

$

9,188

 

Amortization of debt issuance costs

 

 

3,074

 

 

 

1,542

 

Total interest expense recognized

 

$

21,974

 

 

$

10,730

 

 

The effective interest rate of the 2027 Notes was 4.2% as of December 31, 2023 and 2022. As of December 31, 2023, the unamortized debt issuance cost for the 2027 Notes was $11.8 million and will be amortized over approximately 3.6 years. In 2023, the conditions allowing holders of the Notes to convert were not met. As a result, the 2027 Notes are not convertible at December 31, 2023.

Future minimum payments under the 2027 Notes and 2026 Notes are (in thousands):

Years ending December 31:

 

2027 Notes

 

 

2026 Notes

 

 

Total

 

2024

 

$

18,900

 

 

$

845

 

 

$

19,745

 

2025

 

 

18,900

 

 

 

845

 

 

 

19,745

 

2026

 

 

18,900

 

 

 

21,978

 

 

 

40,878

 

2027

 

 

558,900

 

 

 

 

 

 

558,900

 

Future minimum payments

 

 

615,600

 

 

 

23,668

 

 

 

639,268

 

Less: Interest

 

 

(75,600

)

 

 

(2,536

)

 

 

(78,136

)

Convertible notes, principal amount

 

 

540,000

 

 

 

21,132

 

 

 

561,132

 

Less: Debt issuance costs on the convertible notes

 

 

(11,799

)

 

 

(344

)

 

 

(12,143

)

Net carrying amount of the convertible notes

 

$

528,201

 

 

$

20,788

 

 

$

548,989

 

As of December 31, 2023, the estimated fair value of the 2027 Notes and 2026 Notes was $990.4 million and $168.4 million, respectively, and was based upon observable, Level 2 inputs, including pricing information from recent trades of the convertible notes.

Capped Call Transactions

In connection with the offering of the 2026 Notes, the Company entered into privately-negotiated capped call transactions with one of the underwriters in the offering or its affiliate. On October 24, 2022, we entered into a termination agreement in connection to the capped call transactions and thereby released the capped call counterparties of any further obligations in relation to the capped call transactions. As a result of the termination agreement and unwinding of the capped call transactions, we received gross proceeds of $26.4 million in cash.

v3.24.0.1
Stockholders' Equity
12 Months Ended
Dec. 31, 2023
Equity [Abstract]  
Stockholders' Equity

Note 8 — Stockholders’ Equity

Equity Incentive Plan

Our 2004 Plan provides for us to grant incentive stock options, non-statutory stock options, restricted stock, stock appreciation rights, restricted stock units, performance shares and performance units to employees, directors, and consultants. We may grant options for terms of up to ten years at prices not lower than 100% of the fair market value of our common stock on the date of grant. Options granted to new employees generally vest 25% after one year and monthly thereafter over a period of four years. Options granted to existing employees generally vest monthly over a period of four years.

In May 2022, our stockholders approved an amendment to the 2004 Plan to increase the number of authorized shares reserved for issuance under the 2004 Plan by an additional 6.0 million shares. In May 2022 and February 2023, our board of directors approved an amendment to the 2004 Plan to increase the number of authorized shares reserved for issuance under the 2004 Plan by an additional 1.6 million shares and 1.0 million shares, respectively, for inducement grants to new employees. As of December 31, 2023, the total authorized shares under the 2004 Plan available for grant was 7.6 million.

Our annual grant of stock-based compensation takes place during the first quarter of each year. Stock option activity in 2023, 2022, and 2021 was as follows:

 

 

Stock Options
Outstanding

 

 

Weighted
Average Exercise
Price per Share

 

 

Weighted
Average
Remaining
Contractual Life
(in years)

 

 

Aggregate
Intrinsic Value
(in millions)

 

 Balance at December 31, 2020

 

 

8,501,949

 

 

$

10.02

 

 

 

 

 

 

 

 Granted

 

 

2,513,350

 

 

 

22.43

 

 

 

 

 

 

 

 Exercised

 

 

(1,346,194

)

 

 

9.01

 

 

 

 

 

 

 

 Forfeited

 

 

(296,146

)

 

 

14.56

 

 

 

 

 

 

 

 Balance at December 31, 2021

 

 

9,372,959

 

 

$

13.35

 

 

 

 

 

 

 

 Granted

 

 

3,424,150

 

 

 

39.79

 

 

 

 

 

 

 

 Exercised

 

 

(1,389,031

)

 

 

10.13

 

 

 

 

 

 

 

 Forfeited

 

 

(415,675

)

 

 

28.94

 

 

 

 

 

 

 

 Balance at December 31, 2022

 

 

10,992,403

 

 

$

22.13

 

 

 

 

 

 

 

 Granted

 

 

2,447,225

 

 

 

38.59

 

 

 

 

 

 

 

 Exercised

 

 

(1,200,895

)

 

 

12.13

 

 

 

 

 

 

 

 Forfeited

 

 

(458,503

)

 

 

35.01

 

 

 

 

 

 

 

 Balance at December 31, 2023

 

 

11,780,230

 

 

$

26.07

 

 

 

6.8

 

 

$

676.4

 

 Exercisable at December 31, 2023

 

 

7,279,310

 

 

$

19.29

 

 

 

5.7

 

 

$

467.3

 

We have elected to account for forfeitures as they occur. The intrinsic value of stock options exercised, calculated based on the difference between the market value at the date of exercise and the exercise price, was $33.8 million for 2023, $46.3 million for 2022, and $29.3 million for 2021. The intrinsic value of stock options outstanding at December 31, 2023 was $676.4 million.

RSU, including PSU, activity in 2023, 2022, and 2021 was as follows:

 

 

Number of
Restricted
Stock Units

 

 

Weighted
Average Award
Date Fair Value
per Share

 

 Balance at December 31, 2020

 

 

1,116,642

 

 

$

11.88

 

 Granted

 

 

1,093,450

 

 

 

21.69

 

 Exercised

 

 

(606,240

)

 

 

11.13

 

 Forfeited

 

 

(189,025

)

 

 

21.32

 

 Balance at December 31, 2021

 

 

1,414,827

 

 

$

18.52

 

 Granted

 

 

780,519

 

 

 

37.69

 

 Exercised

 

 

(707,772

)

 

 

16.72

 

 Forfeited

 

 

(273,310

)

 

 

26.65

 

 Balance at December 31, 2022

 

 

1,214,264

 

 

$

30.07

 

 Granted

 

 

965,863

 

 

 

39.09

 

 Exercised

 

 

(721,215

)

 

 

27.40

 

 Forfeited

 

 

(84,290

)

 

 

35.46

 

 Balance at December 31, 2023

 

 

1,374,622

 

 

$

37.47

 

RSUs generally vest annually over two to three years. For 2023, the fair value of RSUs vested, calculated based on the units vested multiplied by the closing price of our common stock on the date of vesting, was $28.6 million.

Performance Stock Units

In May 2021, the Compensation Committee granted a total of 375,000 PSUs to certain employees with a weighted average grant date fair value of $25.32 per unit. The fair value of the PSUs was determined on the grant date based on the fair value of the Company’s common stock at such time. The PSUs consist of two equal tranches with 50% of each tranche vesting upon achieving certain performance criteria and 50% vesting at the one-year anniversary of such achievement provided the recipient has been continuously employed by the Company. The first tranche vests upon certification by the Compensation Committee that the NDA for omecamtiv mecarbil has been filed and accepted by the FDA by December 31, 2021 or June 30, 2022 and the second tranche vests upon certification by the Compensation Committee that the FDA approval of the NDA is with an approved label that is consistent with the expectations underlying the Company’s commercial launch plans for omecamtiv mecarbil in effect immediately prior to such approval by June 30, 2022 or December 31, 2022.

In 2022, the performance target for the first tranche of PSUs was met. As a result, the Company recognized expense of $0.7 million in 2022 for the first tranche of PSUs. The performance target for the second tranche of PSUs was not met, and therefore, such second tranche of PSUs consisting of 182,500 PSUs were deemed forfeited as of December 31, 2022. No expense was recognized for the second tranche.

Employee Stock Purchase Plan

Under our ESPP, employees may purchase common stock up to a specified maximum amount at a price equal to 85% of the fair market value at certain plan-defined dates. In May 2020, the Company’s stockholders approved an amendment to the ESPP to increase the number of common stock shares reserved for issuance under the ESPP by 0.5 million shares.

We issued 136,065 shares at an average price of $30.43 per share during 2023, 98,153 shares at an average price of $32.89 per share in 2022, and 108,780 shares at an average price of $16.33 per share in 2021 pursuant to the ESPP. At December 31, 2023, we have 103,822 shares of common stock reserved for issuance under the ESPP.

Stock-Based Compensation Expense

We use the Black-Scholes option pricing model to determine the fair value of stock option grants to employees and directors and employee stock purchase plan shares. The fair value of share-based payments was estimated on the date of grant based on the following assumptions:

 

 

Year Ended December
31, 2023

 

Year Ended December
31, 2022

 

Year Ended December
31, 2021

 

 

Options

 

ESPP

 

Options

 

ESPP

 

Options

 

ESPP

Risk-free interest rate

 

3.57% to 4.6%

 

5.33% to 5.44%

 

1.41% to 4.01%

 

1.63% to 4.65%

 

0.58% to 1.28%

 

0.05%

Volatility

 

67%

 

49% to 50%

 

66% to 67%

 

64% to 65%

 

66% to 67%

 

66% to 67%

Expected term in years

 

6.3

 

0.5

 

6.3 to 6.4

 

0.5

 

6.4 to 6.5

 

0.5

Expected dividend yield

 

0%

 

0%

 

0%

 

0%

 

0%

 

0%

We use U.S. Treasury zero-coupon issues with remaining terms similar to the expected terms of the options for the risk-free interest rate. We use our own volatility history based on our stock trading history and our own historical exercise to estimate expected term for option grants. We do not anticipate paying dividends in the foreseeable future and use an expected dividend yield of zero. We do not estimate forfeitures in our stock-based compensation.

We measure compensation expense for restricted stock units at fair value on the date of grant and recognize the expense over the expected vesting period. We recognize stock-based compensation expense on a ratable basis over the requisite service period, generally the vesting period of the award for share-based awards.

Stock-based compensation expense for 2023, 2022, and 2021 was as follows (in thousands):

 

 

Years Ended December 31,

 

 

 

2023

 

 

2022

 

 

2021

 

Research and development

 

$

32,134

 

 

$

19,100

 

 

$

10,463

 

General and administrative

 

 

39,931

 

 

 

28,753

 

 

 

16,369

 

 

 

$

72,065

 

 

$

47,853

 

 

$

26,832

 

As of December 31, 2023, we expect to recognize $102.2 million of unrecognized compensation cost related to unvested stock options over a weighted-average period of 2.5 years, $29.2 million of unrecognized compensation cost related to unvested restricted stock over a weighted-average period of 1.6 years.

Warrants

In May 2022, Silicon Valley Bank exercised 16,901 warrants issued pursuant to the Term Loan Agreement with a strike price of $7.10 per share and elected the cashless settlement method. In June 2022, Silicon Valley Bank exercised additional 9,226 warrants and 8,638 warrants with a strike price of $9.76 per share and $10.42 per share, respectively. Accordingly, in 2022, we issued to Silicon Valley Bank a total of 28,306 shares of our common stock.

As of December 31, 2023 and 2022, we had the following warrants outstanding to purchase shares of our common stock:

Issuance Date

 

Expiration Date

 

Exercise Price

 

 

Warrants Outstanding at
 December 31, 2022

 

 

Warrants Outstanding at
 December 31, 2023

 

January 2020

 

January 2030

 

$

10.42

 

 

 

12,957

 

 

 

12,957

 

The remaining 12,957 warrants outstanding at December 31, 2023 were exercised in January 2024.

Controlled Equity Offering Sales Agreement with Cantor Fitzgerald & Co.

On March 1, 2023, we entered into the Amended ATM Facility, with Cantor, under which we may offer and sell, from time to time at our sole discretion, shares of the Common Stock having an aggregate offering price of up to $300.0 million through Cantor, as sales agent. The Amended ATM Facility amends, restates and supersedes the Controlled Equity Offering Sales Agreement dated as of March 6, 2019 between the Company and Cantor.

Cantor may sell the Common Stock by any method that is deemed to be an “at the market offering” as defined in Rule 415 of the Securities Act of 1933, as amended, including sales made directly on the Nasdaq Global Select Market or any other trading market for our common stock. Cantor will use commercially reasonable efforts to sell the Common Stock from time to time, based upon instructions from us (including any price, time or size limits or other customary parameters or conditions we may impose). We will pay Cantor a commission of up to 3.0% of the aggregate gross sales proceeds of any common stock sold through Cantor under the Amended ATM Facility, and also have provided Cantor with customary indemnification rights.

In 2023, we issued 5,016,170 shares of our common stock for net proceeds of $164.2 million under the Amended ATM Facility.

v3.24.0.1
Commitments and Contingencies
12 Months Ended
Dec. 31, 2023
Commitments and Contingencies Disclosure [Abstract]  
Commitments and Contingencies

Note 9 — Commitments and Contingencies

Operating Leases

In July 2019, we entered into the Oyster Point Lease of office and laboratory space at a facility located in South San Francisco, California, and we entered into amendments to the Oyster Point Lease in 2020, 2021, 2022, and 2023. The Oyster Point Lease commenced on March 31, 2021 and has an expiration date of October 31, 2033.

In January 2022, we entered into a series of lease agreements with the sub-landlord and landlord and leased an office space at a facility located in Radnor, Pennsylvania (the "Radnor Lease"). The Radnor Lease commenced on September 1, 2022, when the leasehold improvements were substantially completed, and we gained control over the use of the underlying assets. The Radnor Lease has an expiration date of July 31, 2027 with one five-year option to extend the lease.

The weighted-average remaining lease term of the operating leases was 9.7 years, 10.7 years, and 11.7 years as of December 31, 2023, 2022, and 2021, respectively. The weighted-average discount rate used to determine the related operating lease liabilities was 8.7% as of December 31, 2023 and 2022, and 10.0% as of December 31, 2021.

Cash paid for operating leases for the years ended December 31, 2023, 2022, and 2021 was $17.8 million, $24.1 million, and $6.1 million, respectively, and was included in net cash used in operating activities in our consolidated statements of cash flows.

Finance Leases

During the third quarter of 2021, we entered into a master lease agreement for laboratory equipment leases that commenced in the fourth quarter of 2021. The leases have an initial term of 3 years, commenced through the second quarter of 2022 and expire in 2025. The master lease agreement provides a purchase option with a bargain purchase price, which we expect to exercise at the end of the term. The Company classified the leases as finance leases.

Finance leases are accounted for on the consolidated balance sheets with right-of-use assets and lease liabilities recognized in property and equipment, other current liabilities, and other non-current liabilities, respectively. The finance lease cost is recognized as a combination of the amortization expense for the right-of-use assets calculated on a straight-line basis over the five-year estimated useful life for laboratory equipment and interest expense for the outstanding lease liabilities using the determined discount rates. As of December 31, 2023, we have recognized finance lease right-of-use assets of $1.8 million, short-term finance lease liabilities of $1.0 million, and long-term finance lease liabilities of $0.2 million.

As of December 31, 2023, 2022, and 2021, the weighted average remaining lease term for the finance leases is 3.0 years, 4.0 years, and 4.9 years, respectively. The weighted average discount rate used to determine the finance lease liabilities is 9.5% as of December 31, 2023, 2022, and 2021.

The cash paid for finance lease for the years ended December 31, 2023 and 2022 was $0.9 million and was included in financing activities in our consolidated statement of cash flows. No cash was paid for finance lease in 2021.

Future minimum lease payments under non-cancellable leases as of December 31, 2023 is as follows (in thousands):

Years ending December 31:

 

Operating Leases

 

 

Finance Leases

 

2024

 

$

18,738

 

 

$

990

 

2025

 

 

19,563

 

 

 

204

 

2026

 

 

20,180

 

 

 

-

 

2027

 

 

20,514

 

 

 

 

2028

 

 

20,738

 

 

 

 

Thereafter

 

 

109,981

 

 

 

 

Total future minimum lease payments

 

 

209,714

 

 

 

1,194

 

Less: Imputed interest

 

 

(71,396

)

 

 

(51

)

Total lease liability

 

$

138,318

 

 

$

1,143

 

Rent expense for operating and finance leases was $22.1 million, $21.6 million, and $23.1 million for 2023, 2022, and 2021, respectively.

v3.24.0.1
Income Taxes
12 Months Ended
Dec. 31, 2023
Income Tax Disclosure [Abstract]  
Income Taxes

Note 10 — Income Taxes

We did not record an income tax provision in 2023, 2022, and 2021 because we had net taxable losses. Our significant jurisdictions are the United States and California.

The following reconciles the statutory federal income tax rate to our effective tax rate:

 

 

Years Ended December 31,

 

 

 

2023

 

 

2022

 

 

2021

 

Tax at federal statutory tax rate

 

 

21

%

 

 

21

%

 

 

21

%

State tax, net of federal benefits

 

 

1

%

 

 

1

%

 

 

0

%

Change in state effected rates

 

 

0

%

 

 

0

%

 

 

(1

)%

Tax credits, net

 

 

4

%

 

 

4

%

 

 

3

%

Change in valuation allowance

 

 

(24

)%

 

 

(26

)%

 

 

(24

)%

Stock-based compensation

 

 

1

%

 

 

2

%

 

 

2

%

Other

 

 

(3

)%

 

 

(2

)%

 

 

(1

)%

Total

 

 

0

%

 

 

0

%

 

 

0

%

Deferred tax assets, net, reflecting the net tax effect of temporary differences between the carrying amounts of assets and liabilities for financial reporting purposes and the amounts used for income tax purposes, were as follows (in thousands):

 

 

As of December 31,

 

 

 

2023

 

 

2022

 

Deferred tax assets:

 

 

 

 

 

 

Net operating loss carryforwards

 

$

231,915

 

 

$

202,459

 

Tax credits

 

 

119,815

 

 

 

98,292

 

Liability related to sale of future royalties

 

 

85,501

 

 

 

68,366

 

Reserves and accruals

 

 

35,466

 

 

 

23,950

 

Capitalized R&D

 

 

95,437

 

 

 

48,047

 

Long-term lease liability

 

 

28,634

 

 

 

28,901

 

Total noncurrent deferred tax assets

 

 

596,768

 

 

 

470,015

 

Deferred tax liabilities:

 

 

 

 

 

 

Depreciation and amortization

 

 

(6,842

)

 

 

(7,909

)

Operating lease right-of-use assets

 

 

(17,392

)

 

 

(18,192

)

Unrealized Loss

 

 

(6

)

 

 

 

Total noncurrent deferred tax liabilities

 

 

(24,240

)

 

 

(26,101

)

Less: Valuation allowance

 

 

(572,528

)

 

 

(443,914

)

Net deferred tax assets

 

$

 

 

$

 

Realization of deferred tax assets is dependent upon future earnings, if any, the timing and amount of which are uncertain. Based upon the weight of available evidence, which includes our historical operating performance, reported cumulative net losses since inception, expected future losses, and difficulty in accurately forecasting our future results and an assessment of both positive and negative evidence when determining whether it is more likely than not that deferred tax assets are recoverable, we maintained a full valuation allowance on the net deferred tax assets as of December 31, 2023 and 2022. The valuation allowance increased by $128.6 million in 2023 and increased by $116.5 million in 2022.

At December 31, 2023 federal NOL carryforwards were $955.7 million, apportioned state NOL carryforwards before federal benefits were $423.7 million, and foreign NOL carryforwards were $0.8 million. If not utilized, federal and state net operating loss carryforwards incurred prior to 2018 will begin to expire in various amounts beginning 2024 and 2028, respectively, and the foreign net operating loss carryforwards will begin to expire in 2030.

At December 31, 2023, tax credits of $126.3 million and $22.8 million for federal and California income tax purposes, respectively consisted of Research and Development Credits and Orphan Drug Credits. If not utilized, the federal carryforwards will expire in various amounts beginning in 2024. California based credit carryforwards do not expire.

In general, under Section 382, a corporation that undergoes an ‘ownership change’ is subject to limitations on its ability to utilize its pre-change net operating losses and tax credits to offset future taxable income. We do not believe it has experienced an ownership change since 2006, however, a portion of its NOLs and tax credits prior to 2007 will be subject to limitations under Section 382.

Activity related to our gross unrecognized tax benefits were (in thousands):

 

 

Years Ended December 31,

 

 

 

2023

 

 

2022

 

 

2021

 

Balance at the beginning of the year

 

$

18,355

 

 

$

11,295

 

 

$

10,522

 

Increase related to prior year tax positions

 

 

 

 

 

4,438

 

 

 

 

Decrease related to prior year tax positions

 

 

(97

)

 

 

(1,804

)

 

 

(29

)

Increase related to current year tax positions

 

 

6,974

 

 

 

4,426

 

 

 

802

 

Balance at the end of the year

 

$

25,232

 

 

$

18,355

 

 

$

11,295

 

We are subject to federal and various state & local and foreign income tax examinations for all fiscal years with unutilized NOLs and tax credit carryforwards. Included in the balance of unrecognized tax benefits as of December 31, 2023, 2022, and 2021 are $24.5 million, $17.7 million, and $10.3 million of tax benefits, respectively, that, if recognized, would result in adjustments to other tax accounts, primarily deferred taxes.

The Inflation Reduction Act of 2022, or IRA, was signed into law on August 16, 2022. The bill was meant to address the high inflation rate in the United States through various climate, energy, healthcare, and other incentives. These incentives are meant to be paid for by the tax provisions included in the IRA, such as a new 15 percent corporate minimum tax, a 1 percent new excise tax on stock buybacks, additional IRS funding to improve taxpayer compliance, and others. The IRA provisions are effective for tax years beginning after December 31, 2022. At this time, none of the IRA tax provisions are expected to have a material impact to our consolidated tax provision for the year ending December 31, 2023. The Company will continue to closely monitor any effects from future legislation.

In October 2021, the Organization for Economic Co-operation and Development (“OECD”)/G20 finalized the significant components of a two-pillar global tax reform plan, which has now been agreed to by the majority of OECD members. Pillar Two requires multinational enterprises with annual global revenue exceeding €750 million to pay a global minimum tax of 15%. The Company does not currently expect to meet the €750 million revenue threshold. The Company will continue to evaluate the potential impact on future periods of the Pillar Two framework and the implementation of the Pillar Two rules in the jurisdictions in which it operates.

v3.24.0.1
Subsequent Events
12 Months Ended
Dec. 31, 2023
Subsequent Events [Abstract]  
Subsequent Events

Note 11 — Subsequent Events

During the period January 1, 2024 through and inclusive of February 27, 2024, we sold 1,237,460 shares of our common stock for net proceeds of $93.6 million under the Amended ATM Facility.


 

v3.24.0.1
Organization and Accounting Policies (Policies)
12 Months Ended
Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]  
Organization

Organization

Cytokinetics, Incorporated (the “Company”, “we” or “our”) was incorporated under the laws of the state of Delaware on August 5, 1997. We are a late-stage biopharmaceutical company focused on the discovery and development of novel small molecule therapeutics that modulate muscle function for the potential treatment of serious diseases and medical conditions.

Our financial statements contemplate the conduct of our operations in the normal course of business. We have incurred an accumulated deficit of approximately $2.1 billion since inception and there can be no assurance that we will attain profitability. We had a net loss of $526.2 million and net cash used in operations of $414.3 million for the year ended December 31, 2023. Cash, cash equivalents, and investments decreased to $655.4 million as of December 31, 2023 from $829.3 million as of December 31, 2022. We anticipate that we will have operating losses and net cash outflows in future periods.

We are subject to risks common to late-stage biopharmaceutical companies including, but not limited to, development of new drug candidates, dependence on key personnel, and the ability to obtain additional capital as needed to fund our future plans. Our liquidity will be impaired if sufficient additional capital is not available on terms acceptable to us. To date, we have funded operations primarily through sales of our common stock, contract payments under our collaboration agreements, sales of future revenues and royalties, debt financing arrangements, government grants and interest income. Until we achieve profitable operations, we intend to continue to fund operations through payments from strategic collaborations, additional sales of equity securities, grants and debt financings. We have never generated revenues from commercial sales of our drugs and may not have drugs to market for several years, if ever. Our success is dependent on our ability to enter into new strategic collaborations and/or raise additional capital and to successfully develop and market one or more of our drug candidates. We cannot be certain that sufficient funds will be available from such a financing or through a collaborator when required or on satisfactory terms. Additionally, there can be no assurance that our drug candidates will be accepted in the marketplace or that any future products can be developed or manufactured at an acceptable cost. These factors could have a material adverse effect on our future financial results, financial position and cash flows.

Based on the current status of our research and development activities, we believe that our existing cash, cash equivalents, and investments will be sufficient to fund cash requirements for at least the next 12 months after the issuance of these consolidated financial statements. If, at any time, our prospects for financing our research and development programs decline, we may decide to reduce research and development expenses by delaying, discontinuing or reducing our funding of one or more of our research or development programs. Alternatively, we might raise funds through strategic collaborations, public or private financings or other arrangements. Such funding, if needed, may not be available on favorable terms, or at all. The financial statements do not include any adjustments that might result from the outcome of this uncertainty.

Use of Estimates

Use of Estimates

The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosures of contingent liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting periods. We evaluate our estimates on an ongoing basis. We base our estimates on our historical experience and also on assumptions that we believe are reasonable; however, actual results could significantly differ from those estimates.

Basis of Presentation

Basis of Presentation

The consolidated financial statements include the accounts of Cytokinetics, Incorporated and its wholly-owned subsidiaries and have been prepared in accordance with GAAP. Intercompany transactions and balances have been eliminated in consolidation. Certain prior period amounts have been reclassified to conform the prior period presentation to the current year.
Concentration of Credit Risk and Other Risks and Uncertainties

Concentration of Credit Risk and Other Risks and Uncertainties

Financial instruments that potentially subject us to concentrations of risk consist principally of cash, cash equivalents, restricted cash, investments, and accounts receivable.

Our cash, cash equivalents, restricted cash, and investments held with large financial institutions in the United States and deposits may exceed the Federal Deposit Insurance Corporation’s insurance limit.

Drug candidates we develop may require approvals or clearances from the FDA or other regulatory agencies prior to commercial sales. There can be no assurance that our drug candidates will receive any of the required approvals or clearances. If we were to be denied approval, or clearance or any such approval or clearance was to be delayed, it would have a material adverse impact on us.

Cash, Cash Equivalents, and Restricted Cash

Cash, Cash Equivalents, and Restricted Cash

We consider all highly liquid investments with a maturity of three months or less at the time of purchase to be cash equivalents, which consist of money market funds and repurchase agreements backed by U.S. Treasury securities. Repurchase agreements are collateralized by US Treasury securities for an amount not less than 102% of their value and are reported at a carrying value which approximates fair value due to their short duration.

A reconciliation of cash, cash equivalents, and restricted cash reported in our consolidated balance sheets to the amount reported within our consolidated statements of cash flows was as follows (in thousands):

 

 

December 31,

 

 

 

2023

 

 

2022

 

Cash and cash equivalents

 

$

113,024

 

 

$

65,582

 

Restricted cash

 

 

375

 

 

 

1,600

 

Total cash, cash equivalents, and restricted cash as reported within our consolidated statement of cash flows

 

$

113,399

 

 

$

67,182

 

As of December 31, 2023, our restricted cash balance of $0.4 million is used to collateralize letters of credit.

Investments

Investments

Our investments consist of U.S. Treasury securities, U.S. government agency securities, commercial paper, corporate obligations, and money market funds. We designate all investments as available-for-sale and report them at fair value, based on quoted market prices, with unrealized gains and losses recorded in accumulated other comprehensive loss. The cost of securities sold is based on the specific-identification method. Investments with original maturities greater than three months and remaining maturities of one year or less are classified as short-term investments. Investments with remaining maturities greater than one year are classified as long-term investments.

All of our available-for-sale investments are subject to a periodic impairment review. For each available-for-sale investment whose fair value is below its amortized cost, we determine if the impairment is a result of a credit-related loss or other factors using both quantitative and qualitative factors. If the impairment is a result of a credit-related loss, we recognize an allowance for credit losses. If the impairment is not a result of a credit loss, we recognize the loss in other comprehensive loss.

Property and Equipment, net

Property and Equipment, net

Property and equipment are stated at cost less accumulated depreciation and are depreciated on a straight-line basis over the estimated useful lives of the related assets, which are generally three years for computer equipment and software, five years for laboratory equipment and office equipment, and seven years for furniture and fixtures. Amortization of leasehold improvements and finance lease right-of-use assets are computed using the straight-line method over the shorter of the remaining lease term or the estimated useful life of the related assets, typically ranging from three to twelve years. Upon sale or retirement of assets, the costs and related accumulated depreciation and amortization are removed from the balance sheet and the resulting gain or loss is reflected in operations.

Impairment of Long-lived Assets

Impairment of Long-lived Assets

We review long-lived assets, including property, equipment and right-of-use assets, for impairment whenever events or changes in business circumstances indicate that the carrying amount of the assets may not be fully recoverable. Impairment is measured as the amount by which the carrying amount of a long-lived asset exceeds its fair value. We would recognize an impairment loss when estimated undiscounted future cash flows expected to result from the use of the asset and its eventual disposition are less than its carrying amount.

Leases

Leases

We determine if the arrangement contains a lease at inception based on whether the contract conveys the right to control the use of an identified asset. The lease classification is determined at lease commencement, which is the date the underlying asset is available for use by the Company, and preliminary based on whether the arrangement is effectively a financed purchase of the underlying asset (finance lease) or not (operating lease). We determined the lease term at the commencement date by considering whether renewal options and termination options are reasonably assured of exercise. In addition to the fixed minimum lease payments required under the lease arrangements, certain leases include payments of operating expenses that may be revised based on the landlord’s estimate. These variable payments are excluded from the lease payments used to determine the right-of-use asset and lease liability and are recognized when the associated activity occurs.

We recognize right-of-use assets and short-term and long-term lease liabilities on our consolidated balance sheets for operating leases. The right-of-use asset and short-term and long-term lease liabilities for finance leases are recognized in property and equipment, other current liabilities, and other non-current liabilities, respectively, on the consolidated balance sheets.

In determining the present value of lease payments, we estimated our incremental borrowing rate based on information available upon commencement. We base the lease liabilities on the present value of remaining lease payments over the remaining terms of the leases using an estimated rate of interest that we would pay to borrow equivalent funds on a collateralized basis at the lease commencement date. The initial right-of-use asset, for both operating and finance leases, is measured based on the lease liability adjusted for any initial direct costs, lease prepayments, and lease incentives.

We recognize rent expense for operating leases on a straight-line basis over the lease term in operating expenses on the consolidated statements of operations. Finance lease right-of-use assets are amortized on a straight-line basis over the shorter of the expected useful life or the lease term, and the carrying amount of the lease liability is adjusted to reflect interest, which is recorded in interest expense.

We exclude from our consolidated balance sheets recognition of leases having a term of 12 months or less (short-term leases). We account for lease and non-lease components as a single component for our operating leases.

Revenue Recognition

Revenue Recognition

We recognize revenue when we transfer promised goods or services to customers in an amount that reflects the consideration for those goods or services.

At contract inception, we assess the goods or services promised within each contract and assess whether each promised good or service is distinct and determine those that are performance obligations. For example, a license to our intellectual property is determined to be distinct from other performance obligations if licensee is able to use and benefit from the license on its own. Otherwise, licenses are bundled with other promises, such as ongoing research and development services, as combined performance obligation.

We enter into collaborative arrangements with partners that typically include payment to us for one of more of the following: (i) up-front license fees; (ii) milestone payments related to the achievement of developmental, regulatory, or commercial goals; (iii) royalties on net sales of licensed products; and (iv) research and development cost reimbursements. Up-front license fees are included in the transaction price. Development and regulatory milestone payments are included in the transaction price using the most likely amount method, if we conclude it is probable that a significant revenue reversal would not occur. For contracts that include sales-based royalties or sales-based milestones, we recognize revenue at the later of (i) when the related sales occur, or (ii) when the performance obligation to which some or all of the royalty or sales-based milestone has been allocated has been satisfied.

Our joint programs with Astellas under the Astellas OSSA Agreement, and with Amgen under the Amgen Agreement (both of the Astellas OSSA Agreement and the Amgen Agreement having now been terminated), included promises of research and development services. We also entered into the Astellas FSRA Agreement on April 23, 2020. Under the Astellas FSRA Agreement, Astellas agreed to pay one-third of the out-of-pocket clinical development costs which may be incurred in connection with the Company’s Phase 3 clinical trial of reldesemtiv in ALS, up to a maximum contribution by Astellas of $12.0 million. We determined that these services collectively were distinct from any licenses provided to Astellas and Amgen under such agreements, and as such, these services were accounted for as a separate performance obligation recorded over time. We recognized revenue for these services as the performance obligations were satisfied, which we estimated using internal research and development costs incurred.

When a collaborative agreement has more than one performance obligation, we must develop estimates and assumptions that require judgment to determine the underlying stand-alone selling price for each performance obligation which determines how the transaction price is allocated among the performance obligations. The stand-alone selling price may include such items as, forecasted revenues, development timelines, reimbursement rates for personnel costs, discount rates and probabilities of technical and regulatory success, to determine the transaction price to allocate to each performance obligation.

For performance obligations that consist of the delivery of an intellectual property license, the revenue is recognized at the point in time that the license is delivered. For combined performance obligations consisting of an intellectual property license and research and development services, we recognize the combined performance obligation over time, using an input method, as the research and development services are performed.

We are required to make estimates related to the determination of the transaction price and our measurement of how revenue is recognized over time, using the input method. Any changes in these estimates are recorded on a cumulative catch-up basis, which would affect license, collaboration and other revenues and earnings in the period of adjustment.

Accrued Research and Development Expenditures

Accrued Research and Development Expenditures

Clinical trial costs are a component of research and development expense. We accrue and expense clinical trial activities performed by third parties based upon actual work completed in accordance with agreements established with clinical research and manufacturing organizations and clinical sites. We determine the actual costs through monitoring patient enrollment, discussions with internal personnel and external service providers regarding the progress or stage of completion of trials or services and the agreed-upon fee to be paid for such services.

Revenue Participation Right Purchase Agreements

Revenue Participation Right Purchase Agreements

We have entered into certain revenue participation right purchase agreements with certain investors, pursuant to which such investors purchased rights to royalties from certain revenue streams in exchange for consideration. We typically account for such agreements as liabilities to be amortized under the effective interest rate method over the life of the related royalty stream, when we have continuing involvement with the underlying R&D. We typically account for such agreements as deferred income to be amortized under the units-of-revenue method, when there is no continuing involvement with the underlying R&D. We are required to update our estimates, at each reporting period, related to the amount and timing of future royalty payments to be paid to the counterparties of the revenue participation right purchase agreements. The estimates of the future royalty payment determine the measurement of the non-cash interest expense and the carrying value of the liability.

Revenue participation right purchase agreements are measured using significant unobservable inputs. The estimates of future royalties requires the use of several assumptions such as: the probability of clinical success, the probability of regulatory approval, the estimated date of a product launch, estimates of eligible patient populations, estimates of prescribing behavior and patient compliance behavior, estimates of pricing, payor reimbursement and coverage, and sales ramp. As products containing aficamten and omecamtiv mecarbil have not yet been commercialized, the estimates are highly subjective.

In 2020, we entered into a royalty purchase agreement, pursuant to which we sold our right to receive certain payments on the net sales of products containing the compound mavacamten. The consideration received was deferred income to be amortized under the units-of-revenue method, as there was no continuing involvement with the underlying R&D. In 2022, we entered into a tripartite agreement with RTW ICAV and MyoKardia, Inc. acknowledging the release and discharge of any further obligations by us or MyoKardia, Inc. in connection to the Mavacamten Royalty and consequently we recognized the deferred revenue as Realization of revenue participation right purchase agreement on the income statement.

As of December 31, 2023, we have a total carrying value of approximately $380.0 million of liabilities related to revenue participation right purchase agreements.

Research and Development Expenditures

Research and Development Expenditures

Research and development costs are charged to operations as incurred. Research and development expenses consist primarily of clinical manufacturing costs, preclinical study expenses, consulting and other third-party costs, employee compensation, supplies and materials, allocation of overhead and occupancy costs, facilities costs and depreciation of equipment.

Income Taxes

Income Taxes

We account for income taxes under the asset and liability method. Under this method, deferred tax assets and liabilities are determined based on the difference between the financial statement and tax basis of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to affect taxable income. Valuation allowances are established when necessary to reduce deferred tax assets to the amounts expected to be realized.

We recognize uncertain tax positions taken or expected to be taken on a tax return. Tax positions are initially recognized when it is more likely than not that the position will be sustained upon examination by the tax authorities. Such tax positions are initially and subsequently measured as the largest amount of tax benefit that is more likely than not of being realized upon ultimate settlement with the tax authority assuming full knowledge of the position and relevant facts.

We recognize interest accrued related to unrecognized tax benefits and penalties as income tax expense.

Stock-Based Compensation

Stock-Based Compensation

We maintain equity incentive plans under which incentive stock options may be granted to employees and nonqualified stock options, restricted stock awards, performance-based stock units and stock appreciation rights may be granted to employees, directors, consultants and advisors. In addition, we maintain an ESPP under which employees may purchase shares of our common stock through payroll deductions.

Stock-based compensation expense related to stock options granted to employees and directors is recognized based on the grant date estimated fair values using the Black Scholes option pricing model. The value of the portion of the award that is ultimately expected to vest is recognized as expense ratably over the requisite service period.

Stock-based compensation expense related to performance-based stock units granted to employees is recognized based on the grant-date fair value of each award and recorded as expense over the vesting period using the ratable method when the underlying performance conditions are deemed probable.

Stock-based compensation expense related to the ESPP is recognized based on the fair value of each award estimated on the first day of the offering period using the Black Scholes option pricing model and recorded as expense over the service period using the straight-line method.

v3.24.0.1
Organization and Accounting Policies (Tables)
12 Months Ended
Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]  
Reconciliation of Cash, Cash Equivalents, and Restricted Cash

A reconciliation of cash, cash equivalents, and restricted cash reported in our consolidated balance sheets to the amount reported within our consolidated statements of cash flows was as follows (in thousands):

 

 

December 31,

 

 

 

2023

 

 

2022

 

Cash and cash equivalents

 

$

113,024

 

 

$

65,582

 

Restricted cash

 

 

375

 

 

 

1,600

 

Total cash, cash equivalents, and restricted cash as reported within our consolidated statement of cash flows

 

$

113,399

 

 

$

67,182

 

v3.24.0.1
Net Loss Per Share (Tables)
12 Months Ended
Dec. 31, 2023
Earnings Per Share [Abstract]  
Instruments Excluded from the Computation of Diluted Net Loss Per Share

The following instruments were excluded from the computation of diluted net loss per share for the periods presented because their effect would have been antidilutive (in thousands):

 

 

Years Ended December 31,

 

 

 

2023

 

 

2022

 

 

2021

 

Options to purchase common stock

 

 

11,780

 

 

 

10,992

 

 

 

9,373

 

Warrants to purchase common stock

 

 

13

 

 

 

13

 

 

 

48

 

Restricted stock and performance units

 

 

1,375

 

 

 

1,260

 

 

 

1,415

 

Shares issuable related to the ESPP

 

 

16

 

 

 

13

 

 

 

8

 

Shares issuable upon conversion of 2026 Notes

 

 

2,003

 

 

 

2,003

 

 

 

16,675

 

Shares issuable upon conversion of 2027 Notes

 

 

10,572

 

 

 

10,572

 

 

 

 

Total shares

 

 

25,759

 

 

 

24,853

 

 

 

27,519

 

v3.24.0.1
Fair Value Measurements (Tables)
12 Months Ended
Dec. 31, 2023
Fair Value Disclosures [Abstract]  
Summary of Fair Value of Financial Assets Consists of Cash Equivalents and Investments Classified as Available-for-sale Securities Measured on Recurring Basis

The follow tables set forth the fair value of our financial assets, which consists of cash equivalents and investments classified as available-for-sale securities, that were measured on a recurring basis (in thousands):

 

 

December 31, 2023

 

 

 

Fair Value Hierarchy Level

 

Amortized
Cost

 

 

Unrealized
Gains

 

 

Unrealized
Losses

 

 

Fair
Value

 

Money market funds

 

Level 1

 

$

77,429

 

 

$

 

 

$

 

 

$

77,429

 

U.S. Treasury securities

 

Level 1

 

 

34,625

 

 

 

13

 

 

 

(15

)

 

 

34,623

 

U.S. Government agency securities

 

Level 2

 

 

175,301

 

 

 

87

 

 

 

(133

)

 

 

175,255

 

Commercial paper

 

Level 2

 

 

252,956

 

 

 

156

 

 

 

(59

)

 

 

253,053

 

Corporate obligations

 

Level 2

 

 

92,384

 

 

 

103

 

 

 

(142

)

 

 

92,345

 

 

 

 

 

$

632,695

 

 

$

359

 

 

$

(349

)

 

$

632,705

 

 

 

 

December 31, 2022

 

 

 

Fair Value Hierarchy Level

 

Amortized
Cost

 

 

Unrealized
Gains

 

 

Unrealized
Losses

 

 

Fair
Value

 

Money market funds

 

Level 1

 

$

45,887

 

 

$

 

 

$

 

 

$

45,887

 

U.S. Treasury securities

 

Level 1

 

 

172,568

 

 

 

 

 

 

(1,102

)

 

 

171,466

 

U.S. Treasury securities backed repurchase agreements

 

Level 2

 

 

16,003

 

 

 

 

 

 

 

 

 

16,003

 

U.S. Government agency securities

 

Level 2

 

 

129,174

 

 

 

12

 

 

 

(820

)

 

 

128,366

 

Foreign government agency securities

 

Level 2

 

 

7,599

 

 

 

 

 

 

(69

)

 

 

7,530

 

Commercial paper

 

Level 2

 

 

329,359

 

 

 

28

 

 

 

(431

)

 

 

328,956

 

Corporate obligations

 

Level 2

 

 

128,594

 

 

 

 

 

 

(1,209

)

 

 

127,385

 

 

 

 

 

$

829,184

 

 

$

40

 

 

$

(3,631

)

 

$

825,593

 

v3.24.0.1
Balance Sheet Components (Tables)
12 Months Ended
Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]  
Summary of Property and Equipment

Our property and equipment consisted of (in thousands):

 

 

December 31,

 

 

 

2023

 

 

2022

 

Property and equipment, net:

 

 

 

 

 

 

Laboratory equipment

 

$

18,839

 

 

$

18,490

 

Computer equipment and software

 

 

3,263

 

 

 

3,900

 

Office equipment, furniture and fixtures

 

 

6,061

 

 

 

6,056

 

Leasehold improvements

 

 

66,874

 

 

 

65,912

 

Construction in progress

 

 

220

 

 

 

741

 

Right-of-use assets, finance lease

 

 

1,839

 

 

 

2,448

 

Total property and equipment

 

 

97,096

 

 

 

97,547

 

Less: Accumulated depreciation

 

 

(28,348

)

 

 

(17,094

)

 

 

$

68,748

 

 

$

80,453

 

Summary of Accrued Liabilities

Our accrued liabilities were as follows (in thousands):

 

 

December 31,

 

 

 

2023

 

 

2022

 

Accrued liabilities:

 

 

 

 

 

 

Clinical and preclinical costs

 

$

5,880

 

 

$

16,105

 

Compensation related

 

 

29,255

 

 

 

21,767

 

Other accrued expenses

 

 

7,506

 

 

 

6,224

 

Total accrued liabilities

 

$

42,641

 

 

$

44,096

 

v3.24.0.1
Agreements with Royalty Pharma (Tables)
12 Months Ended
Dec. 31, 2023
Agreements with Royalty Pharma [Abstract]  
Schedule of Initial Consideration

The initial consideration was allocated as follows (in thousands):

 

 

Fair Value

 

 

Proceeds

 

 

Allocation

 

Units of Accounting:

 

 

 

 

 

 

 

 

 

Revenue Participation Right Purchase Agreement

 

$

69,498

 

 

$

100,000

 

 

$

89,571

 

Development Funding Loan Agreement

 

 

46,887

 

 

 

50,000

 

 

 

60,429

 

Total consideration

 

$

116,385

 

 

$

150,000

 

 

$

150,000

 

 

Schedule of Future Minimum Payments under the Existing Borrowing Under Term Loan Agreement

Future minimum payments under the existing borrowing under RP Loan Agreement are (in thousands):

Years ending December 31:

 

 

 

2024

 

$

10,080

 

2025

 

 

11,520

 

2026

 

 

11,520

 

2027

 

 

11,520

 

2028

 

 

11,520

 

Thereafter

 

 

37,440

 

Future minimum payments

 

 

93,600

 

Less: Unamortized interest and loan costs

 

 

(25,136

)

Term Loan, net

 

$

68,464

 

Schedule of Activity within Liabilities Related to Sale of Future Royalties

Changes to the RP Aficamten Liability and the RP OM Liability are as follows (in thousands):

 

 

RP Aficamten Liability

 

 

RP OM Liability

 

 

 

2023

 

 

2022

 

 

2023

 

 

2022

 

 

2021

 

 Beginning balance, January 1

 

$

105,117

 

 

$

 

 

$

195,384

 

 

$

179,072

 

 

$

166,068

 

 Initial carrying value

 

 

 

 

 

89,571

 

 

 

 

 

 

 

 

 

 

 Additional consideration

 

 

50,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 Interest accretion

 

 

25,474

 

 

 

15,546

 

 

 

3,888

 

 

 

16,196

 

 

 

12,892

 

 Amortization of issuance costs

 

 

 

 

 

 

 

 

112

 

 

 

116

 

 

 

112

 

 Ending balance, December 31

 

$

180,591

 

 

$

105,117

 

 

$

199,384

 

 

$

195,384

 

 

$

179,072

 

v3.24.0.1
Debt (Tables)
12 Months Ended
Dec. 31, 2023
Debt Disclosure [Abstract]  
Schedule of Interest Cost Relating to Notes

The following table presents the total amount of interest cost recognized relating to the 2026 Notes (in thousands):

 

 

Years Ended December 31,

 

 

 

2023

 

 

2022

 

 

2021

 

Contractual interest expense

 

$

844

 

 

$

3,265

 

 

$

5,520

 

Accretion of debt discount

 

 

 

 

 

 

 

 

5,907

 

Amortization of debt issuance costs

 

 

108

 

 

 

355

 

 

 

59

 

Total interest expense recognized

 

$

952

 

 

$

3,620

 

 

$

11,486

 

The following table presents the total amount of interest cost recognized relating to the 2027 Notes (in thousands):

 

 

2023

 

 

2022

 

Contractual interest expense

 

$

18,900

 

 

$

9,188

 

Amortization of debt issuance costs

 

 

3,074

 

 

 

1,542

 

Total interest expense recognized

 

$

21,974

 

 

$

10,730

 

 

Schedule of Maturities of Notes

Future minimum payments under the 2027 Notes and 2026 Notes are (in thousands):

Years ending December 31:

 

2027 Notes

 

 

2026 Notes

 

 

Total

 

2024

 

$

18,900

 

 

$

845

 

 

$

19,745

 

2025

 

 

18,900

 

 

 

845

 

 

 

19,745

 

2026

 

 

18,900

 

 

 

21,978

 

 

 

40,878

 

2027

 

 

558,900

 

 

 

 

 

 

558,900

 

Future minimum payments

 

 

615,600

 

 

 

23,668

 

 

 

639,268

 

Less: Interest

 

 

(75,600

)

 

 

(2,536

)

 

 

(78,136

)

Convertible notes, principal amount

 

 

540,000

 

 

 

21,132

 

 

 

561,132

 

Less: Debt issuance costs on the convertible notes

 

 

(11,799

)

 

 

(344

)

 

 

(12,143

)

Net carrying amount of the convertible notes

 

$

528,201

 

 

$

20,788

 

 

$

548,989

 

v3.24.0.1
Stockholders' Equity (Tables)
12 Months Ended
Dec. 31, 2023
Equity [Abstract]  
Summary of Stock Option Activity Stock option activity in 2023, 2022, and 2021 was as follows:

 

 

Stock Options
Outstanding

 

 

Weighted
Average Exercise
Price per Share

 

 

Weighted
Average
Remaining
Contractual Life
(in years)

 

 

Aggregate
Intrinsic Value
(in millions)

 

 Balance at December 31, 2020

 

 

8,501,949

 

 

$

10.02

 

 

 

 

 

 

 

 Granted

 

 

2,513,350

 

 

 

22.43

 

 

 

 

 

 

 

 Exercised

 

 

(1,346,194

)

 

 

9.01

 

 

 

 

 

 

 

 Forfeited

 

 

(296,146

)

 

 

14.56

 

 

 

 

 

 

 

 Balance at December 31, 2021

 

 

9,372,959

 

 

$

13.35

 

 

 

 

 

 

 

 Granted

 

 

3,424,150

 

 

 

39.79

 

 

 

 

 

 

 

 Exercised

 

 

(1,389,031

)

 

 

10.13

 

 

 

 

 

 

 

 Forfeited

 

 

(415,675

)

 

 

28.94

 

 

 

 

 

 

 

 Balance at December 31, 2022

 

 

10,992,403

 

 

$

22.13

 

 

 

 

 

 

 

 Granted

 

 

2,447,225

 

 

 

38.59

 

 

 

 

 

 

 

 Exercised

 

 

(1,200,895

)

 

 

12.13

 

 

 

 

 

 

 

 Forfeited

 

 

(458,503

)

 

 

35.01

 

 

 

 

 

 

 

 Balance at December 31, 2023

 

 

11,780,230

 

 

$

26.07

 

 

 

6.8

 

 

$

676.4

 

 Exercisable at December 31, 2023

 

 

7,279,310

 

 

$

19.29

 

 

 

5.7

 

 

$

467.3

 

Summary of Restricted Stock Unit Activity Including Performance Stock Units

RSU, including PSU, activity in 2023, 2022, and 2021 was as follows:

 

 

Number of
Restricted
Stock Units

 

 

Weighted
Average Award
Date Fair Value
per Share

 

 Balance at December 31, 2020

 

 

1,116,642

 

 

$

11.88

 

 Granted

 

 

1,093,450

 

 

 

21.69

 

 Exercised

 

 

(606,240

)

 

 

11.13

 

 Forfeited

 

 

(189,025

)

 

 

21.32

 

 Balance at December 31, 2021

 

 

1,414,827

 

 

$

18.52

 

 Granted

 

 

780,519

 

 

 

37.69

 

 Exercised

 

 

(707,772

)

 

 

16.72

 

 Forfeited

 

 

(273,310

)

 

 

26.65

 

 Balance at December 31, 2022

 

 

1,214,264

 

 

$

30.07

 

 Granted

 

 

965,863

 

 

 

39.09

 

 Exercised

 

 

(721,215

)

 

 

27.40

 

 Forfeited

 

 

(84,290

)

 

 

35.46

 

 Balance at December 31, 2023

 

 

1,374,622

 

 

$

37.47

 

Fair Value of Share-Based Payments was Estimated on Date of Grant Based on Assumptions

We use the Black-Scholes option pricing model to determine the fair value of stock option grants to employees and directors and employee stock purchase plan shares. The fair value of share-based payments was estimated on the date of grant based on the following assumptions:

 

 

Year Ended December
31, 2023

 

Year Ended December
31, 2022

 

Year Ended December
31, 2021

 

 

Options

 

ESPP

 

Options

 

ESPP

 

Options

 

ESPP

Risk-free interest rate

 

3.57% to 4.6%

 

5.33% to 5.44%

 

1.41% to 4.01%

 

1.63% to 4.65%

 

0.58% to 1.28%

 

0.05%

Volatility

 

67%

 

49% to 50%

 

66% to 67%

 

64% to 65%

 

66% to 67%

 

66% to 67%

Expected term in years

 

6.3

 

0.5

 

6.3 to 6.4

 

0.5

 

6.4 to 6.5

 

0.5

Expected dividend yield

 

0%

 

0%

 

0%

 

0%

 

0%

 

0%

Summary of Stock-Based Compensation Expense

Stock-based compensation expense for 2023, 2022, and 2021 was as follows (in thousands):

 

 

Years Ended December 31,

 

 

 

2023

 

 

2022

 

 

2021

 

Research and development

 

$

32,134

 

 

$

19,100

 

 

$

10,463

 

General and administrative

 

 

39,931

 

 

 

28,753

 

 

 

16,369

 

 

 

$

72,065

 

 

$

47,853

 

 

$

26,832

 

Summary of Warrants Outstanding to Purchase Shares of Common Stock

As of December 31, 2023 and 2022, we had the following warrants outstanding to purchase shares of our common stock:

Issuance Date

 

Expiration Date

 

Exercise Price

 

 

Warrants Outstanding at
 December 31, 2022

 

 

Warrants Outstanding at
 December 31, 2023

 

January 2020

 

January 2030

 

$

10.42

 

 

 

12,957

 

 

 

12,957

 

v3.24.0.1
Commitments and Contingencies (Tables)
12 Months Ended
Dec. 31, 2023
Commitments and Contingencies Disclosure [Abstract]  
Schedule of Future Minimum Lease Payments under Non-cancellable Lease

Future minimum lease payments under non-cancellable leases as of December 31, 2023 is as follows (in thousands):

Years ending December 31:

 

Operating Leases

 

 

Finance Leases

 

2024

 

$

18,738

 

 

$

990

 

2025

 

 

19,563

 

 

 

204

 

2026

 

 

20,180

 

 

 

-

 

2027

 

 

20,514

 

 

 

 

2028

 

 

20,738

 

 

 

 

Thereafter

 

 

109,981

 

 

 

 

Total future minimum lease payments

 

 

209,714

 

 

 

1,194

 

Less: Imputed interest

 

 

(71,396

)

 

 

(51

)

Total lease liability

 

$

138,318

 

 

$

1,143

 

v3.24.0.1
Income Taxes (Tables)
12 Months Ended
Dec. 31, 2023
Income Tax Disclosure [Abstract]  
Reconciliation of Statutory Federal Income Tax Rate to Effective Tax Rate

The following reconciles the statutory federal income tax rate to our effective tax rate:

 

 

Years Ended December 31,

 

 

 

2023

 

 

2022

 

 

2021

 

Tax at federal statutory tax rate

 

 

21

%

 

 

21

%

 

 

21

%

State tax, net of federal benefits

 

 

1

%

 

 

1

%

 

 

0

%

Change in state effected rates

 

 

0

%

 

 

0

%

 

 

(1

)%

Tax credits, net

 

 

4

%

 

 

4

%

 

 

3

%

Change in valuation allowance

 

 

(24

)%

 

 

(26

)%

 

 

(24

)%

Stock-based compensation

 

 

1

%

 

 

2

%

 

 

2

%

Other

 

 

(3

)%

 

 

(2

)%

 

 

(1

)%

Total

 

 

0

%

 

 

0

%

 

 

0

%

Summary of Deferred Tax Assets, Net

Deferred tax assets, net, reflecting the net tax effect of temporary differences between the carrying amounts of assets and liabilities for financial reporting purposes and the amounts used for income tax purposes, were as follows (in thousands):

 

 

As of December 31,

 

 

 

2023

 

 

2022

 

Deferred tax assets:

 

 

 

 

 

 

Net operating loss carryforwards

 

$

231,915

 

 

$

202,459

 

Tax credits

 

 

119,815

 

 

 

98,292

 

Liability related to sale of future royalties

 

 

85,501

 

 

 

68,366

 

Reserves and accruals

 

 

35,466

 

 

 

23,950

 

Capitalized R&D

 

 

95,437

 

 

 

48,047

 

Long-term lease liability

 

 

28,634

 

 

 

28,901

 

Total noncurrent deferred tax assets

 

 

596,768

 

 

 

470,015

 

Deferred tax liabilities:

 

 

 

 

 

 

Depreciation and amortization

 

 

(6,842

)

 

 

(7,909

)

Operating lease right-of-use assets

 

 

(17,392

)

 

 

(18,192

)

Unrealized Loss

 

 

(6

)

 

 

 

Total noncurrent deferred tax liabilities

 

 

(24,240

)

 

 

(26,101

)

Less: Valuation allowance

 

 

(572,528

)

 

 

(443,914

)

Net deferred tax assets

 

$

 

 

$

 

Schedule of Activity Related to our Gross Unrecognized Tax Benefits

Activity related to our gross unrecognized tax benefits were (in thousands):

 

 

Years Ended December 31,

 

 

 

2023

 

 

2022

 

 

2021

 

Balance at the beginning of the year

 

$

18,355

 

 

$

11,295

 

 

$

10,522

 

Increase related to prior year tax positions

 

 

 

 

 

4,438

 

 

 

 

Decrease related to prior year tax positions

 

 

(97

)

 

 

(1,804

)

 

 

(29

)

Increase related to current year tax positions

 

 

6,974

 

 

 

4,426

 

 

 

802

 

Balance at the end of the year

 

$

25,232

 

 

$

18,355

 

 

$

11,295

 

v3.24.0.1
Organization and Accounting Policies - Additional Information (Detail) - USD ($)
$ in Thousands
12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Summary Of Significant Accounting Policies [Line Items]      
Accumulated deficit incurred $ (2,112,238) $ (1,585,994)  
Net loss (526,244) (388,955) $ (215,314)
Net cash used in operating activities 414,333 299,516 $ 142,522
Cash, cash equivalents and investments $ 655,400 829,300  
Cash requirements term 12 months    
Restricted cash $ 375 1,600  
Liabilities related to revenue participation right purchase agreements, net $ 379,975 $ 300,501  
Maximum [Member]      
Summary Of Significant Accounting Policies [Line Items]      
Percentage of securities collateralized value 102.00%    
Computer Equipment and Software [Member]      
Summary Of Significant Accounting Policies [Line Items]      
Property and equipment estimated useful lives 3 years    
Laboratory Equipment and Office Equipment [Member]      
Summary Of Significant Accounting Policies [Line Items]      
Property and equipment estimated useful lives 5 years    
Furniture and Fixtures [Member]      
Summary Of Significant Accounting Policies [Line Items]      
Property and equipment estimated useful lives 7 years    
Leasehold Improvements [Member] | Minimum [Member]      
Summary Of Significant Accounting Policies [Line Items]      
Property and equipment estimated useful lives 3 years    
Leasehold Improvements [Member] | Maximum [Member]      
Summary Of Significant Accounting Policies [Line Items]      
Property and equipment estimated useful lives 12 years    
Astellas [Member] | Astellas FSRA Agreement [Member]      
Summary Of Significant Accounting Policies [Line Items]      
Payment of development costs for clinical trials of reldesemtiv $ 12,000    
v3.24.0.1
Organization and Accounting Policies - Reconciliation of Cash, Cash Equivalents, and Restricted Cash Equivalents (Details) - USD ($)
$ in Thousands
Dec. 31, 2023
Dec. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]    
Cash and cash equivalents $ 113,024 $ 65,582
Restricted cash 375 1,600
Total cash, cash equivalents, and restricted cash as reported within our consolidated statement of cash flows $ 113,399 $ 67,182
v3.24.0.1
Net Loss Per Share - Instruments Excluded from the Computation of Diluted Net Loss Per Share (Detail) - shares
shares in Thousands
12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]      
Total shares 25,759 24,853 27,519
Options to Purchase Common Stock [Member]      
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]      
Total shares 11,780 10,992 9,373
Warrants to Purchase Common Stock [Member]      
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]      
Total shares 13 13 48
Restricted Stock and Performance Units [Member]      
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]      
Total shares 1,375 1,260 1,415
Shares Issuable Related to the ESSP [Member]      
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]      
Total shares 16 13 8
2026 Notes [Member]      
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]      
Total shares 2,003 2,003 16,675
2027 Notes [Member]      
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]      
Total shares 10,572 10,572 0
v3.24.0.1
Research and Development Arrangements - Additional Information (Detail) - USD ($)
3 Months Ended 12 Months Ended
Dec. 20, 2021
Apr. 23, 2020
Sep. 30, 2021
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Sep. 30, 2022
Jul. 14, 2020
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                  
Total revenues       $ 7,530,000 $ 94,588,000 $ 70,428,000      
Accounts receivable       1,283,000 147,000        
Amount received as milestone payment     $ 5,000,000 2,500,000          
Net proceeds of issuance of common stock       164,233,000          
Ji Xing Omecamtiv Mecarbil License and Collaboration Agreement [Member]                  
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                  
Nonrefundable payment obligation $ 50,000,000                
Amount received as milestone payment $ 50,000,000                
Ji Xing Aficamten License and Collaboration Agreement [Member]                  
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                  
Accounts receivable       300,000 100,000        
Upfront payment received                 $ 25,000,000
Royalty Purchase Agreement [Member]                  
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                  
Total revenues         87,000,000        
Sale of interest in future royalties                 85,000,000
Fair Value of Royalty             $ 87,000,000    
Long-term deferred revenue               $ 87,000,000  
Common Stock Purchase Agreement [Member]                  
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                  
Issuance of common stock upon private placement, shares 511,182                
Shares Issued, price per share $ 39.125                
Net proceeds of issuance of common stock $ 20,000,000                
Common stock purchase agreement date Dec. 20, 2021                
Excess amount paid over the fair value of the shares $ 4,900,000                
Fair value of common stock 15,100,000                
Maximum [Member] | Ji Xing Omecamtiv Mecarbil License and Collaboration Agreement [Member]                  
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                  
Potential additional payments receivable 330,000,000                
Maximum [Member] | Ji Xing Aficamten License and Collaboration Agreement [Member]                  
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                  
Potential additional payments receivable                 $ 200,000,000
2016 Astellas Amendment [Member] | Maximum [Member]                  
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                  
Payment of development costs for clinical trials of reldesemtiv   $ 12,000,000              
Reimbursement of clinical development costs       12,000,000          
Rights Granted [Member] | Ji Xing Omecamtiv Mecarbil License and Collaboration Agreement [Member]                  
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                  
Nonrefundable payment obligation 40,000,000                
New Drug Application [Member] | Ji Xing Omecamtiv Mecarbil License and Collaboration Agreement [Member]                  
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                  
Nonrefundable payment obligation $ 10,000,000                
License Revenues [Member]                  
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                  
Total revenues       0 0 54,856,000      
License Revenues [Member] | Ji Xing Aficamten License and Collaboration Agreement [Member]                  
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                  
Total revenues             $ 36,500,000    
Research and Development Revenues [Member]                  
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                  
Total revenues       4,030,000 6,588,000 10,572,000      
Research and Development Revenues [Member] | Ji Xing Aficamten License and Collaboration Agreement [Member]                  
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                  
Total revenues       1,300,000 900,000 0      
Amgen | Research And Development Milestone Grant And Other Revenues Net                  
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                  
Total revenues       0 0 7,400,000      
Astellas [Member] | Accounting Standards Update 2014-09                  
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                  
Accounts receivable       0 0        
Astellas [Member] | Research and Development Revenues [Member]                  
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items]                  
Total revenues       $ 2,700,000 $ 5,700,000 $ 3,200,000      
v3.24.0.1
Fair Value Measurements - Summary of Fair Value of Financial Assets Consists of Cash Equivalents and Investments Classified as Available-for-sale Securities Measured on Recurring Basis (Detail) - Fair Value, Measurements, Recurring [Member] - Cash and Cash Equivalents and Investments [Member] - USD ($)
$ in Thousands
Dec. 31, 2023
Dec. 31, 2022
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]    
Amortized Cost $ 632,695 $ 829,184
Unrealized Gains 359 40
Unrealized Losses (349) (3,631)
Fair Value 632,705 825,593
Money Market Funds [Member] | Fair Value Measurements Using Level 1 [Member]    
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]    
Amortized Cost 77,429 45,887
Unrealized Gains 0 0
Unrealized Losses 0 0
Fair Value 77,429 45,887
U.S. Treasury Securities [Member] | Fair Value Measurements Using Level 1 [Member]    
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]    
Amortized Cost 34,625 172,568
Unrealized Gains 13 0
Unrealized Losses (15) (1,102)
Fair Value 34,623 171,466
U.S. Government agency securities | Fair Value Measurements Using Level 2 [Member]    
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]    
Amortized Cost 175,301 129,174
Unrealized Gains 87 12
Unrealized Losses (133) (820)
Fair Value 175,255 128,366
U.S. Treasury Securities Backed Repurchase Agreements [Member] | Fair Value Measurements Using Level 2 [Member]    
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]    
Amortized Cost   16,003
Unrealized Gains   0
Unrealized Losses   0
Fair Value   16,003
Foreign government agency securities | Fair Value Measurements Using Level 2 [Member]    
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]    
Amortized Cost   7,599
Unrealized Gains   0
Unrealized Losses   (69)
Fair Value   7,530
Commercial Paper [Member] | Fair Value Measurements Using Level 2 [Member]    
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]    
Amortized Cost 252,956 329,359
Unrealized Gains 156 28
Unrealized Losses (59) (431)
Fair Value 253,053 328,956
Corporate Obligations [Member] | Fair Value Measurements Using Level 2 [Member]    
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]    
Amortized Cost 92,384 128,594
Unrealized Gains 103 0
Unrealized Losses (142) (1,209)
Fair Value $ 92,345 $ 127,385
v3.24.0.1
Fair Value Measurements - Additional Information (Detail) - USD ($)
12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Fair Value Disclosures [Abstract]    
Credit losses on debt securities $ 0 $ 0
v3.24.0.1
Balance Sheet Components - Summary of Property and Equipment (Detail) - USD ($)
$ in Thousands
Dec. 31, 2023
Dec. 31, 2022
Property Plant And Equipment [Line Items]    
Total property and equipment $ 97,096 $ 97,547
Less: Accumulated depreciation (28,348) (17,094)
Total property and equipment, net 68,748 80,453
Laboratory Equipment [Member]    
Property Plant And Equipment [Line Items]    
Total property and equipment 18,839 18,490
Computer Equipment and Software [Member]    
Property Plant And Equipment [Line Items]    
Total property and equipment 3,263 3,900
Office Equipment, Furniture and Fixtures [Member]    
Property Plant And Equipment [Line Items]    
Total property and equipment 6,061 6,056
Leasehold Improvements [Member]    
Property Plant And Equipment [Line Items]    
Total property and equipment 66,874 65,912
Construction in Progress [Member]    
Property Plant And Equipment [Line Items]    
Total property and equipment 220 741
Right-of-Use Assets, Finance Lease [Member]    
Property Plant And Equipment [Line Items]    
Total property and equipment $ 1,839 $ 2,448
v3.24.0.1
Balance Sheet Components - Additional Information (Detail) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]      
Depreciation expense $ 11.9 $ 5.8 $ 2.3
Employer contributions under the plan $ 2.5 $ 1.8 $ 1.1
v3.24.0.1
Balance Sheet Components - Summary of Accrued Liabilities (Detail) - USD ($)
$ in Thousands
Dec. 31, 2023
Dec. 31, 2022
Accrued liabilities:    
Clinical and preclinical costs $ 5,880 $ 16,105
Compensation related 29,255 21,767
Other accrued expenses 7,506 6,224
Total accrued liabilities $ 42,641 $ 44,096
v3.24.0.1
Agreements with Royalty Pharma - Additional Information (Detail) - USD ($)
$ / shares in Units, $ in Thousands
1 Months Ended 3 Months Ended 12 Months Ended
Jan. 07, 2022
Sep. 30, 2023
Mar. 31, 2022
Feb. 28, 2017
Dec. 31, 2023
Sep. 30, 2023
Jun. 30, 2023
Mar. 31, 2023
Dec. 31, 2022
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Jul. 01, 2023
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                          
Arrangement consideration of debt transaction $ 150,000                        
Long term debt         $ 639,268         $ 639,268      
Debt Instrument, Face Amount         $ 561,132         $ 561,132      
Purchase of common stock shares         101,637,922       94,833,975 101,637,922 94,833,975    
Liabilities         $ 1,210,639       $ 1,122,675 $ 1,210,639 $ 1,122,675    
RP Loan Agreement [Member]                          
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                          
Long term debt         $ 68,464         $ 68,464      
2022 Royalty Pharma Transactions [Member]                          
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                          
Milestone payment 50,000                        
2022 Royalty Pharma Transactions [Member] | RP Aficamten RPA, RPI ICAV [Member]                          
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                          
Upfront payment 50,000                        
Purchased rights to certain revenue streams from net sales in consideration payment $ 50,000                        
Percentage of net sales payable 4.50%                        
4.5% of net revenue to be receivable from annual worldwide net sales $ 1,000,000                        
Percentage of net sales payable for excess of annual worldwide net sales 3.50%                        
3.5% of net sales payable for excess of annual worldwide net sales $ 1,000,000                        
Imputed rate of interest on unamortized portion of liability         24.80%       22.40% 24.80% 22.40%    
2022 Royalty Pharma Transactions [Member] | RP Aficamten RPA, RPI ICAV [Member] | oHCM [Member]                          
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                          
Additional consideration amount paid of first pivotal clinical trail     $ 50,000                    
2022 Royalty Pharma Transactions [Member] | RP Aficamten RPA, RPI ICAV [Member] | nHCM [Member]                          
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                          
Additional consideration amount paid of first pivotal clinical trail   $ 50,000                      
2022 Royalty Pharma Transactions [Member] | RP Aficamten RPA, RPI ICAV [Member] | Maximum [Member]                          
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                          
Purchased rights to certain revenue streams from net sales in consideration payment $ 150,000                        
2022 Royalty Pharma Transactions [Member] | RP Aficamten RPA, RPI ICAV [Member] | Change in Accounting Estimate [Member]                          
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                          
Imputed rate of interest on unamortized liability   18.00%     24.80% 18.00% 19.00% 22.40% 22.40% 24.80% 22.40%    
Non-cash interest expense recognized         $ 9,800 $ 5,400 $ 4,900 $ 5,400 $ 5,200 $ 25,500 $ 15,500    
Increase in non-cash interest expense and net loss                   $ 2,000      
Increase (reduction) in net loss per share                   $ 0.02      
2022 Royalty Pharma Transactions [Member] | RP Loan Agreement [Member]                          
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                          
Term loan, maturity year 10 years                        
Debt instrument effective interest rate 7.65%                        
Applicable prepayment charges on term loan $ 34,600                        
Debt Instrument, Face Amount $ 50,000                        
Estimated fair value of long term debt         $ 59,900         $ 59,900      
2022 Royalty Pharma Transactions [Member] | RP Loan Agreement [Member] | Term Loan Tranche 1, Tranche 4 and Tranche 5 [Member]                          
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                          
Repayable loan percentage to principal amount Including interest and other fees 190.00%                        
2022 Royalty Pharma Transactions [Member] | RP Loan Agreement [Member] | Term Loan Tranche 2 and Tranche 3 [Member]                          
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                          
Repayable loan percentage to principal amount Including interest and other fees 200.00%                        
2022 Royalty Pharma Transactions [Member] | RP Aficamten RPA [Member]                          
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                          
Additional consideration amount paid                   $ 50,000      
Royalty Purchase Finance Trust Agreement [Member]                          
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                          
Imputed rate of interest on unamortized liability         0.10%       8.50% 0.10% 8.50%    
Additional consideration amount paid                   $ 0 $ 0 $ 0  
Royalty Purchase Finance Trust Agreement [Member] | RP OM RPA [Member] | Maximum [Member]                          
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                          
Increase in royalty rate         5.50%         5.50%      
Royalty Purchase Finance Trust Agreement [Member] | RP OM RPA [Member] | Change in Accounting Estimate [Member]                          
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                          
Imputed rate of interest on unamortized liability   2.90%     0.10% 2.90% 2.90% 1.90% 8.50% 0.10% 8.50%    
Non-cash interest expense recognized         $ 100 $ 1,400 $ 1,400 $ 900 $ 4,000 $ 3,900 $ 16,200 $ 12,900  
Increase in non-cash interest expense and net loss                   $ 12,800      
Increase (reduction) in net loss per share                   $ 0.13      
CRL Option [Member] | 2022 Royalty Pharma Transactions [Member] | RP Loan Agreement [Member]                          
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                          
Term loan, maximum borrowing capacity $ 300,000                        
Term loan, current borrowing capacity 50,000                        
Term loan, remaining borrowing capacity 250,000                        
CRL Option [Member] | 2022 Royalty Pharma Transactions [Member] | RP Loan Agreement [Member] | Term Loan Tranche 2 [Member]                          
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                          
Long term debt 50,000                        
CRL Option [Member] | 2022 Royalty Pharma Transactions [Member] | RP Loan Agreement [Member] | Term Loan Tranche 3 [Member]                          
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                          
Long term debt 25,000                        
CRL Option [Member] | 2022 Royalty Pharma Transactions [Member] | RP Loan Agreement [Member] | Term Loan Tranche 4 [Member]                          
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                          
Term loan, maximum borrowing capacity         75,000         $ 75,000      
Long term debt 75,000                        
CRL Option [Member] | 2022 Royalty Pharma Transactions [Member] | RP Loan Agreement [Member] | Term Loan Tranche 4 [Member] | Minimum [Member]                          
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                          
Term loan, current borrowing capacity         50,000         50,000      
CRL Option [Member] | 2022 Royalty Pharma Transactions [Member] | RP Loan Agreement [Member] | Term Loan Tranche 5 [Member]                          
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                          
Term loan, remaining borrowing capacity         $ 100,000         $ 100,000      
Long term debt $ 100,000                        
CRL Option [Member] | Royalty Purchase Finance Trust Agreement [Member]                          
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                          
Cash payment under royalty agreement       $ 90,000                  
Purchase of common stock shares       875,656                  
Stock issued during period, value, issued for services       $ 10,000                  
Liabilities       $ 92,300                  
Additional percent of royalty on net sale       1.00%                  
CRL Option [Member] | Royalty Purchase Finance Trust Agreement [Member] | Minimum [Member]                          
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                          
Percent of royalty on net sale 5.50%     4.50%                  
CRL Option [Member] | Royalty Purchase Finance Trust Agreement [Member] | Maximum [Member]                          
Liabilities Related to Revenue Participation Right Purchase Agreements [Line Items]                          
Increase in royalty rate                         5.50%
v3.24.0.1
Agreements with Royalty Pharma - Schedule of Initial Consideration (Detail) - 2022 Royalty Pharma Transactions [Member]
$ in Thousands
Jan. 07, 2022
USD ($)
Debt Instrument [Line Items]  
Consideration Fair Value $ 116,385
Consideration proceeds 150,000
Consideration allocation 150,000
Revenue Participation Right Purchase Agreements [Member]  
Debt Instrument [Line Items]  
Consideration Fair Value 69,498
Consideration proceeds 100,000
Consideration allocation 89,571
Development Funding Loan Agreement [Member]  
Debt Instrument [Line Items]  
Consideration Fair Value 46,887
Consideration proceeds 50,000
Consideration allocation $ 60,429
v3.24.0.1
Agreements with Royalty Pharma - Schedule of Future Minimum Payments under Term Loan Agreement (Detail)
$ in Thousands
Dec. 31, 2023
USD ($)
Debt Instrument [Line Items]  
2024 $ 19,745
2025 19,745
2026 40,878
2027 558,900
Less: Unamortized interest and loan costs (12,143)
Term Loan, net 639,268
RP Loan Agreement [Member]  
Debt Instrument [Line Items]  
2024 10,080
2025 11,520
2026 11,520
2027 11,520
2028 11,520
Thereafter 37,440
Future minimum payments 93,600
Less: Unamortized interest and loan costs (25,136)
Term Loan, net $ 68,464
v3.24.0.1
Agreements with Royalty Pharma - Schedule Represents Allocation of Transaction Consideration on a Relative Fair Value Basis to the Liability and the Common Stock (Detail) - USD ($)
$ in Thousands
12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
RP Aficamten Liability [Member]      
Royalty Liability [Line Items]      
Liabilities related to revenue participation right purchase agreements, net beginning balance $ 105,117 $ 0  
Initial carrying value 0 89,571  
Additional consideration 50,000 0  
Interest accretion 25,474 15,546  
Amortization of issuance costs 0 0  
Liabilities related to revenue participation right purchase agreements, net ending balance 180,591 105,117 $ 0
RPOM Liability [Member]      
Royalty Liability [Line Items]      
Liabilities related to revenue participation right purchase agreements, net beginning balance 195,384 179,072 166,068
Initial carrying value 0 0 0
Additional consideration 0 0 0
Interest accretion 3,888 16,196 12,892
Amortization of issuance costs 112 116 112
Liabilities related to revenue participation right purchase agreements, net ending balance $ 199,384 $ 195,384 $ 179,072
v3.24.0.1
Debt - Additional Information (Detail)
12 Months Ended
Oct. 24, 2022
USD ($)
Jul. 06, 2022
USD ($)
$ / shares
shares
Nov. 13, 2019
USD ($)
$ / shares
shares
Dec. 31, 2023
USD ($)
Days
$ / shares
Dec. 31, 2022
USD ($)
$ / shares
Dec. 31, 2021
USD ($)
Jan. 06, 2022
USD ($)
Debt Instrument [Line Items]              
Principal amount of original loan       $ 561,132,000      
Loss on extinguishment of debt         $ 2,693,000    
Interest expense       $ 28,306,000 $ 19,414,000 $ 16,440,000  
Common stock, par value | $ / shares       $ 0.001 $ 0.001    
Oxford and Silicon Valley Bank [Member] | Term Loan Agreement [Member]              
Debt Instrument [Line Items]              
Principal amount of original loan             $ 45,000,000
Loss on extinguishment of debt         $ 2,700,000    
Oxford and Silicon Valley Bank [Member] | 2019 Term Loan [Member] | Term Loan Agreement [Member]              
Debt Instrument [Line Items]              
Interest expense           $ 4,800,000  
2026 Notes [Member]              
Debt Instrument [Line Items]              
Principal amount of original loan     $ 138,000,000 $ 21,132,000      
Issuance of shares of common stock | shares   8,071,343          
Repurchase of principal amount of original loan   $ 116,900,000          
Inducement loss as a result of partial repurchase   22,200,000          
Aggregate principal amount remaining       $ 21,100,000      
Number of instalments description       payable semi-annually on May 15 and December 15 of each year, beginning May 15, 2020      
Convertible notes, interest rate     4.00%        
Convertible debt, fair value       $ 168,400,000      
Convertible notes, maturity date     Nov. 15, 2026        
Convertible notes, sinking fund     $ 0        
Convertible notes, shares issued | shares     94.7811        
Convertible notes, principal amount     $ 1,000        
Convertible notes, initial conversion price | $ / shares     $ 10.55        
Convertible notes, type of equity security issued       common stock      
Convertible notes, conversion description       The 2026 Notes are convertible at December 31, 2023 at the option of the holder.      
Convertible notes, redemption description       The 2026 Notes will be redeemable, in whole or in part, at our option at any time, and from time to time, on or after November 20, 2023 and, in the case of any partial redemption, on or before the 60th scheduled trading day before the maturity date, at a cash redemption price equal to the principal amount of the 2026 Notes to be redeemed, plus accrued and unpaid interest, if any, to, but excluding, the redemption date but only if the last reported sale price per share of our common stock exceeds 130% of the conversion price on (1) each of at least 20 trading days, whether or not consecutive, during the 30 consecutive trading days ending on, and including, the trading day immediately before the date we may send the related redemption notice; and (2) the trading day immediately before the date we may send such notice. If a “fundamental change” (as defined in the indenture agreement, dated November 13, 2019 between us and U.S. Bank National Association, as trustee, as supplemented by the first supplemental indenture dated as of November 13, 2019 between us and such trustee) occurs, then, subject to certain exceptions, holders may require us to repurchase their 2026 Notes at a cash repurchase price equal to the principal amount of the 2026 Notes to be repurchased, plus accrued and unpaid interest, if any, to, but excluding, the fundamental change repurchase date.      
Debt instrument, unamortized debt issuance cost       $ 300,000      
Unamortized debt discount amortization period       2 years 10 months 24 days      
Proceeds from termination of capped call options associated with convertible notes $ 26,400,000            
2026 Notes [Member] | Liability [Member]              
Debt Instrument [Line Items]              
Debt instrument effective interest rate       4.60% 4.60% 12.50%  
2027 Notes [Member]              
Debt Instrument [Line Items]              
Principal amount of original loan   540,000,000   $ 540,000,000      
Payment associated with convertible notes   $ 140,300,000          
Number of instalments description   payable semiannually in arrears on January 1 and July 1 of each year, beginning on January 1, 2023          
Convertible notes, interest rate   3.50%          
Convertible debt, fair value       990,400,000      
Convertible notes, maturity date   Jul. 01, 2027          
Convertible notes, shares issued | shares   19.5783          
Convertible notes, principal amount   $ 1,000   $ 1,000      
Convertible notes, initial conversion price | $ / shares   $ 51.08          
Convertible notes, type of equity security issued       common stock      
Net proceeds from convertible notes, net of debt discount and issuance costs   $ 523,600,000          
Convertible notes, conversion description       The 2027 Notes are convertible into cash, shares of our common stock or a combination of cash and shares of our common stock, at our election, based on the applicable conversion rate(s). The initial conversion rate for the 2027 Notes is 19.5783 shares of our common stock per $1,000 principal amount of such Notes, which is equivalent to an initial conversion price of approximately $51.08 per share. Holders of the 2027 Notes may convert all or any portion of their convertible notes at their option only in the following circumstances: (i) during any calendar quarter (and only during such calendar quarter) commencing after the calendar quarter ending on September 30, 2022, if the last reported sale price per share of our common stock, $0.001 par value per share, exceeds 130% of the conversion price for each of at least 20 trading days, whether or not consecutive, during the 30 consecutive trading days ending on, and including, the last trading day of the immediately preceding calendar quarter; (ii) during the five consecutive business days immediately after any 10 consecutive trading day period (such 10 consecutive trading day period, the “measurement period”) if the trading price per $1,000 principal amount of 2027 Notes for each trading day of the measurement period was less than 98% of the product of the last reported sale price per share of our common stock on such trading day and the conversion rate on such trading day; (iii) upon the occurrence of certain corporate events or distributions on our common stock, as described in the 2027 Indenture; (iv) if we call such 2027 Notes for redemption; and (v) at any time from, and including, March 1, 2027 until the close of business on the scheduled trading day immediately before the maturity date.      
Convertible notes, redemption description       We may not redeem the 2027 Notes at our option at any time before July 7, 2025. The 2027 Notes will be redeemable, in whole or in part (subject to the “Partial Redemption Limitation” (as defined in the 2027 Indenture)), at our option at any time, and from time to time, on or after July 7, 2025 and, in the case of a partial redemption, on or before the 60th scheduled trading day immediately before the maturity date, at a cash redemption price equal to the principal amount of the 2027 Notes to be redeemed, plus accrued and unpaid interest, if any, to, but excluding, the redemption date, but only if the last reported sale price per share of our common stock exceeds 130% of the conversion price on (i) each of at least 20 trading days, whether or not consecutive, during the 30 consecutive trading days ending on, and including, the trading day immediately before the date we may send the related redemption notice; and (ii) the trading day immediately before the date we may send such notice. In addition, calling any of the 2027 Notes for redemption will constitute a Make-Whole Fundamental Change with respect to that convertible note, in which case the conversion rate applicable to the conversion of that Note will be increased in certain circumstances if it is converted after it is called for redemption. The conversion rate for the 2027 Notes shall not exceed 25.4517 shares per $1,000 principal amount of such Notes, subject to certain customary anti-dilution adjustments (as defined in the 2027 indenture). Pursuant to the Partial Redemption Limitation, we may not elect to redeem less than all of the outstanding 2027 Notes unless at least $75.0 million aggregate principal amount of 2027 Notes are outstanding and not subject to redemption as of the time we may send the related redemption notice.      
Debt instrument, unamortized debt issuance cost       $ 11,800,000      
Unamortized debt discount amortization period       3 years 7 months 6 days      
2027 Notes [Member] | Liability [Member]              
Debt Instrument [Line Items]              
Debt instrument effective interest rate       4.20% 4.20%    
2027 Notes [Member] | Debt Instrument Convertible Covenant One [Member]              
Debt Instrument [Line Items]              
Convertible notes, percentage of conversion price       130.00%      
Convertible notes, trading days | Days       20      
Convertible notes, consecutive trading days | Days       30      
Common stock, par value | $ / shares       $ 0.001      
2027 Notes [Member] | Debt Instrument Convertible Covenant Two [Member]              
Debt Instrument [Line Items]              
Convertible notes, percentage of last reported sale price of common stock       98.00%      
Convertible notes, trading days | Days       5      
Convertible notes, consecutive trading days | Days       10      
2027 Notes [Member] | Maximum [Member]              
Debt Instrument [Line Items]              
Convertible notes, shares issued | shares   25.4517          
2027 Notes [Member] | Minimum [Member]              
Debt Instrument [Line Items]              
Aggregate principal amount of notes outstanding   $ 75,000,000          
v3.24.0.1
Debt - Schedule of Interest Cost Relating to 2026 and 2027 Notes (Detail) - USD ($)
$ in Thousands
12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
2026 Notes [Member]      
Debt Instrument [Line Items]      
Contractual interest expense $ 844 $ 3,265 $ 5,520
Accretion of debt discount 0 0 5,907
Amortization of debt issuance costs 108 355 59
Total interest expense recognized 952 3,620 $ 11,486
2027 Notes [Member]      
Debt Instrument [Line Items]      
Contractual interest expense 18,900 9,188  
Amortization of debt issuance costs 3,074 1,542  
Total interest expense recognized $ 21,974 $ 10,730  
v3.24.0.1
Debt - Schedule of Future Minimum Payments under 2026 Notes (Detail) - USD ($)
$ in Thousands
Dec. 31, 2023
Dec. 31, 2022
Jul. 06, 2022
Nov. 13, 2019
Debt Instrument [Line Items]        
2024 $ 19,745      
2025 19,745      
2026 40,878      
2027 558,900      
Future minimum payments 639,268      
Less: Interest (78,136)      
Convertible notes, principal amount 561,132      
Less: Debt issuance costs on the convertible notes (12,143)      
Net carrying amount of the convertible notes 548,989 $ 545,808    
2026 Notes [Member]        
Debt Instrument [Line Items]        
2024 845      
2025 845      
2026 21,978      
2027 0      
Future minimum payments 23,668      
Less: Interest (2,536)      
Convertible notes, principal amount 21,132     $ 138,000
Less: Debt issuance costs on the convertible notes (344)      
Net carrying amount of the convertible notes 20,788      
2027 Notes [Member]        
Debt Instrument [Line Items]        
2024 18,900      
2025 18,900      
2026 18,900      
2027 558,900      
Future minimum payments 615,600      
Less: Interest (75,600)      
Convertible notes, principal amount 540,000   $ 540,000  
Less: Debt issuance costs on the convertible notes (11,799)      
Net carrying amount of the convertible notes $ 528,201      
v3.24.0.1
Stockholders' Equity - Additional Information (Detail)
1 Months Ended 12 Months Ended
May 31, 2022
$ / shares
shares
Jun. 30, 2022
$ / shares
shares
May 31, 2021
Tranche
$ / shares
shares
May 31, 2020
shares
Dec. 31, 2023
USD ($)
$ / shares
shares
Dec. 31, 2022
USD ($)
$ / shares
shares
Dec. 31, 2021
USD ($)
$ / shares
shares
Mar. 01, 2023
USD ($)
Feb. 28, 2023
shares
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]                  
Intrinsic value of stock options outstanding | $         $ 676,400,000        
Allocated share based compensation expense | $         $ 72,065,000 $ 47,853,000 $ 26,832,000    
Outstanding warrants         12,957        
Issuance of common stock under at-the-market offering, net of issuance costs, shares         101,637,922 94,833,975      
Proceeds from issuance of common stock related to at-the-market offering, net of issuance costs | $         $ 164,233,000        
Common Stock [Member]                  
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]                  
Issuance of common stock pursuant to ESPP, shares         136,065 98,153 108,780    
Amended ATM Facility [Member] | Cantor [Member]                  
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]                  
Maximum offering price of common stock under At The Market agreement | $               $ 300,000,000  
Maximum percentage commission to be paid on gross proceedings under at the market agreement               3.00%  
Issuance of common stock under at-the-market offering, net of issuance costs, shares         5,016,170        
Proceeds from issuance of common stock related to at-the-market offering, net of issuance costs | $         $ 164,200,000        
Oxford and Silicon Valley Bank [Member] | New Loan and Security Agreement [Member] | 2019 Term Loan [Member] | Common Stock [Member]                  
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]                  
Outstanding warrants           28,306      
Oxford and Silicon Valley Bank [Member] | New Loan and Security Agreement [Member] | 2019 Term Loan [Member] | Warrants exercised in May 2022 [Member]                  
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]                  
Warrants exercise price | $ / shares $ 7.1                
Warrants exercised 16,901                
Oxford and Silicon Valley Bank [Member] | New Loan and Security Agreement [Member] | 2019 Term Loan [Member] | Warrants exercised in June 2022 [Member]                  
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]                  
Warrants exercise price | $ / shares   $ 9.76              
Warrants exercised   9,226              
Oxford and Silicon Valley Bank [Member] | New Loan and Security Agreement [Member] | 2019 Term Loan [Member] | Warrants exercised in June 2022 [Member]                  
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]                  
Warrants exercise price | $ / shares   $ 10.42              
Warrants exercised   8,638              
Restricted Stock Units (RSUs)                  
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]                  
Share based compensation, vested restricted stock units, total fair value | $         28,600,000        
Unamortized/unrecognized stock-based compensation expense | $         $ 29,200,000        
Weighted-average period         1 year 7 months 6 days        
Restricted Stock Units (RSUs) | Minimum [Member]                  
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]                  
Vesting period         2 years        
Restricted Stock Units (RSUs) | Maximum [Member]                  
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]                  
Vesting period         3 years        
Performance Stock Units                  
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]                  
Shares available for grant     375,000            
Per unit weighted average grant date fair value | $ / shares     $ 25.32            
Number of tranche | Tranche     2            
Performance Stock Units | Tranche One                  
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]                  
Share-based compensation arrangement by share based payment award award vesting rights percentage     50.00%            
Allocated share based compensation expense | $           $ 700,000      
Performance Stock Units | Tranche Two                  
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]                  
Share-based compensation arrangement by share based payment award award vesting rights percentage     50.00%            
Number of shares cancelled           182,500      
Allocated share based compensation expense | $           $ 0      
Employee Stock Option [Member]                  
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]                  
Unamortized/unrecognized stock-based compensation expense | $         $ 102,200,000        
Weighted-average period         2 years 6 months        
2004 Plan [Member]                  
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]                  
Option grant prices as percentage of the fair market value of the common stock         100.00%        
Term to grant nonstatutory stock options and incentive stock options         10 years        
Percentage of options grant to new employees         25.00%        
Increase in number of authorized shares reserved for issuance 6,000,000                
Shares available for grant         7,600,000        
Share based compensation, options exercised, total intrinsic value | $         $ 33,800,000 $ 46,300,000 $ 29,300,000    
Intrinsic value of stock options outstanding | $         $ 676,400,000        
2004 Plan [Member] | New Employee [Member]                  
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]                  
Award vesting right         Options granted to new employees generally vest 25% after one year and monthly thereafter over a period of four years        
Period from percentage of stock option vested         1 year        
Vesting period         4 years        
Increase in number of authorized shares reserved for issuance 1,600,000               1,000,000
2004 Plan [Member] | Existing Employee [Member]                  
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]                  
Award vesting right         Options granted to existing employees generally vest monthly over a period of four years        
Vesting period         4 years        
ESPP [Member]                  
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]                  
Option grant prices as percentage of the fair market value of the common stock         85.00%        
Number of authorized shares reserved for issuance         103,822        
Increase in common stock shares reserved for issuance       500,000          
Issuance of common stock pursuant to ESPP, shares         136,065 98,153 108,780    
Issuance of common stock pursuant to ESPP, per share | $ / shares         $ 30.43 $ 32.89 $ 16.33    
v3.24.0.1
Stockholders' Equity - Summary of Stock Option Activity (Detail) - USD ($)
$ / shares in Units, $ in Millions
12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]      
Stock Options Outstanding, Beginning Balance 10,992,403 9,372,959 8,501,949
Stock Options Outstanding, Granted 2,447,225 3,424,150 2,513,350
Stock Options Outstanding, Forfeited (458,503) (415,675) (296,146)
Stock Options Outstanding, Ending Balance 11,780,230 10,992,403 9,372,959
Stock Options Outstanding, Exercisable 7,279,310    
Weighted Average Exercise Price per Share, Beginning Balance $ 22.13 $ 13.35 $ 10.02
Weighted Average Exercise Price per Share, Granted 38.59 39.79 22.43
Weighted Average Exercise Price per Share, Exercised 12.13 10.13 9.01
Weighted Average Exercise Price per Share, Forfeited 35.01 28.94 14.56
Weighted Average Exercise Price per Share, Ending Balance 26.07 $ 22.13 $ 13.35
Weighted Average Exercise Price per Share, Exercisable $ 19.29    
Weighted Average Remaining Contractual Life 6 years 9 months 18 days    
Weighted Average Remaining Contractual Life, Exercisable at December 31, 2023 5 years 8 months 12 days    
Aggregate Intrinsic Value $ 676.4    
Aggregate Intrinsic Value, Exercisable at December 31, 2023 $ 467.3    
Common Stock [Member]      
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]      
Stock Options Outstanding, Exercised (1,200,895) (1,389,031) (1,346,194)
v3.24.0.1
Stockholders' Equity - Summary of Restricted Stock Unit Activity Including Performance Stock Units (Detail) - Restricted Stock Units (RSUs) Including Performance Stock Units (PSUs) - $ / shares
12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]      
Number of Restricted Stock Units, Beginning Balance 1,214,264 1,414,827 1,116,642
Number of Restricted Stock Units, Granted 965,863 780,519 1,093,450
Number of Restricted Stock Units, Exercised (721,215) (707,772) (606,240)
Number of Restricted Stock Units, Forfeited (84,290) (273,310) (189,025)
Number of Restricted Stock Units, Ending Balance 1,374,622 1,214,264 1,414,827
Weighted Average Award Date Fair Value per Share, Beginning Balance $ 30.07 $ 18.52 $ 11.88
Weighted Average Award Date Fair Value per Share, Granted 39.09 37.69 21.69
Weighted Average Award Date Fair Value per Share, Exercised 27.4 16.72 11.13
Weighted Average Award Date Fair Value per Share, Forfeited 35.46 26.65 21.32
Weighted Average Award Date Fair Value per Share, Ending Balance $ 37.47 $ 30.07 $ 18.52
v3.24.0.1
Stockholders' Equity - Fair Value of Share-Based Payments was Estimated on Date of Grant Based on Assumptions (Detail)
12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Employee Stock Option [Member]      
Deferred Compensation Arrangement With Individual Share Based Payments [Line Items]      
Risk-free interest rate, minimum 3.57% 1.41% 0.58%
Risk-free interest rate, maximum 4.60% 4.01% 1.28%
Volatility, minimum   66.00% 66.00%
Volatility, maximum   67.00% 67.00%
Volatility 67.00%    
Expected term in years 6 years 3 months 18 days    
Expected dividend yield 0.00% 0.00% 0.00%
Minimum [Member] | Employee Stock Option [Member]      
Deferred Compensation Arrangement With Individual Share Based Payments [Line Items]      
Expected term in years   6 years 3 months 18 days 6 years 4 months 24 days
Maximum [Member] | Employee Stock Option [Member]      
Deferred Compensation Arrangement With Individual Share Based Payments [Line Items]      
Expected term in years   6 years 4 months 24 days 6 years 6 months
ESPP [Member]      
Deferred Compensation Arrangement With Individual Share Based Payments [Line Items]      
Risk-free interest rate, minimum 5.33% 1.63%  
Risk-free interest rate, maximum 5.44% 4.65%  
Risk-free interest rate     0.05%
Volatility, minimum 49.00% 64.00% 66.00%
Volatility, maximum 50.00% 65.00% 67.00%
Expected term in years 6 months 6 months 6 months
Expected dividend yield 0.00% 0.00% 0.00%
v3.24.0.1
Stockholders' Equity - Summary of Stock-Based Compensation Expense (Detail) - USD ($)
$ in Thousands
12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]      
Stock-based compensation expense $ 72,065 $ 47,853 $ 26,832
Research and Development [Member]      
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]      
Stock-based compensation expense 32,134 19,100 10,463
General and Administrative [Member]      
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]      
Stock-based compensation expense $ 39,931 $ 28,753 $ 16,369
v3.24.0.1
Stockholders' Equity - Summary of Warrants Outstanding to Purchase Shares of Common Stock (Detail)
12 Months Ended
Dec. 31, 2023
$ / shares
shares
Class of Warrant or Right [Line Items]  
Warrants Outstanding 12,957
Oxford and Silicon Valley Bank [Member] | New Loan and Security Agreement [Member] | 2019 Term Loan [Member] | January 2020 [Member]  
Class of Warrant or Right [Line Items]  
Expiration Date 2030-01
Exercise Price | $ / shares $ 10.42
Warrants Outstanding 12,957
v3.24.0.1
Commitments and Contingencies - Additional Information (Detail) - USD ($)
12 Months Ended
Sep. 01, 2022
Mar. 31, 2021
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Lessee Lease Description [Line Items]          
Operating lease, right-of-use assets     $ 78,987,000 $ 82,737,000  
Operating lease, short-term lease liability     17,891,000 12,829,000  
Operating lease, long-term lease liability     $ 120,427,000 126,895,000  
Finance lease, contractual lease term     3 years    
Rent expense for operating and finance leases     $ 22,100,000 $ 21,600,000 $ 23,100,000
Lease Agreement          
Lessee Lease Description [Line Items]          
Operating lease, weighted average remaining lease term     9 years 8 months 12 days 10 years 8 months 12 days 11 years 8 months 12 days
Operating lease, weighted average discount rate     8.70% 8.70% 10.00%
Operating lease, cash paid included in net cash used in operating activities     $ 17,800,000 $ 24,100,000 $ 6,100,000
Financial lease estimated life     5 years    
Finance Lease, Right-of-Use Asset     $ 1,800,000    
Finance Lease, Right-of-Use Asset, Statement of Financial Position [Extensible Enumeration]     Property and equipment, net    
Short term finance lease liability     $ 1,000,000    
Finance Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]     Other current liabilities    
Long term finance lease liability     $ 200,000    
Finance Lease, Liability, Noncurrent, Statement of Financial Position [Extensible Enumeration]     Other non-current liabilities    
Finance lease, weighted average remaining lease term     3 years 4 years 4 years 10 months 24 days
Finance lease, weighted average discount rate     9.50% 9.50% 9.50%
Finance lease payments     $ 900,000 $ 900,000 $ 0
Oyster Point Lease [Member] | California [Member]          
Lessee Lease Description [Line Items]          
Operating lease, lease expiration date     Oct. 31, 2033    
Operating lease, commencement date   Mar. 31, 2021      
Radnor Lease [Member] | Pennsylvania [Member]          
Lessee Lease Description [Line Items]          
Operating lease, lease expiration date     Jul. 31, 2027    
Operating lease, commencement date Sep. 01, 2022        
Operating lease commenced, term description     one five-year option to extend the lease    
v3.24.0.1
Commitments and Contingencies - Schedule of Future Minimum Lease Payments under Non-cancellable Lease (Detail)
$ in Thousands
Dec. 31, 2023
USD ($)
Leases [Abstract]  
2024 $ 18,738
2025 19,563
2026 20,180
2027 20,514
2028 20,738
Thereafter 109,981
Total future minimum lease payments 209,714
Less: Imputed interest (71,396)
Total lease liability 138,318
2024 990
2025 204
2026 0
2027 0
2028 0
Thereafter 0
Total future minimum lease payments 1,194
Less: Imputed interest (51)
Total lease liability $ 1,143
Finance Lease, Liability, Statement of Financial Position [Extensible Enumeration] us-gaap:OtherLiabilities
v3.24.0.1
Income Taxes - Additional Information (Detail)
€ in Millions
1 Months Ended 12 Months Ended
Oct. 31, 2021
EUR (€)
Dec. 31, 2023
USD ($)
Dec. 31, 2022
USD ($)
Dec. 31, 2021
USD ($)
Income Tax Contingency [Line Items]        
Provision for income tax   $ 0 $ 0 $ 0
Increase (decrease) in valuation allowance   $ 128,600,000 116,500,000  
Research and development credits and orphan drug credits, federal carryforwards will expire   2024    
Unrecognized tax benefits   $ 24,500,000 $ 17,700,000 $ 10,300,000
Multinational enterprises with annual global revenue excess capital | € € 750      
Payment of a global minimum tax rate 15.00%      
Revenue threshold | € € 750      
California Income Tax Purposes [Member]        
Income Tax Contingency [Line Items]        
Credit carryforwards for federal and state   22,800,000    
Federal Tax [Member]        
Income Tax Contingency [Line Items]        
Net operating loss carryforwards   $ 955,700,000    
Net operating loss carryforwards expiration   2024    
Credit carryforwards for federal and state   $ 126,300,000    
Federal and State Tax [Member]        
Income Tax Contingency [Line Items]        
Net operating loss carryforwards   $ 423,700,000    
Net operating loss carryforwards expiration   2028    
Foreign Tax Authority [Member]        
Income Tax Contingency [Line Items]        
Net operating loss carryforwards   $ 800,000    
Net operating loss carryforwards expiration   2030    
v3.24.0.1
Income Taxes - Reconciliation of Statutory Federal Income Tax Rate to Effective Tax Rate (Detail)
12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Income Tax Disclosure [Abstract]      
Tax at federal statutory tax rate 21.00% 21.00% 21.00%
State tax, net of federal benefits 1.00% 1.00% 0.00%
Change in state effected rates 0.00% 0.00% (1.00%)
Tax credits, net 4.00% 4.00% 3.00%
Change in valuation allowance (24.00%) (26.00%) (24.00%)
Stock-based compensation 1.00% 2.00% 2.00%
Other (3.00%) (2.00%) (1.00%)
Total 0.00% 0.00% 0.00%
v3.24.0.1
Income Taxes - Summary of Deferred Tax Assets, Net (Detail) - USD ($)
$ in Thousands
Dec. 31, 2023
Dec. 31, 2022
Deferred tax assets:    
Net operating loss carryforwards $ 231,915 $ 202,459
Tax credits 119,815 98,292
Liability related to sale of future royalties 85,501 68,366
Reserves and accruals 35,466 23,950
Capitalized R&D 95,437 48,047
Long-term lease liability 28,634 28,901
Total noncurrent deferred tax assets 596,768 470,015
Deferred tax liabilities:    
Depreciation and amortization (6,842) (7,909)
Operating lease right-of-use assets (17,392) (18,192)
Unrealized Loss (6) 0
Total noncurrent deferred tax liabilities (24,240) (26,101)
Less: Valuation allowance (572,528) (443,914)
Net deferred tax assets $ 0 $ 0
v3.24.0.1
Income Taxes - Schedule of Activity Related to our Gross Unrecognized Tax Benefits (Detail) - USD ($)
$ in Thousands
12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Income Tax Disclosure [Abstract]      
Balance at the beginning of the year $ 18,355 $ 11,295 $ 10,522
Increase related to prior year tax positions   4,438  
Decrease related to prior year tax positions (97) (1,804) (29)
Increase related to current year tax positions 6,974 4,426 802
Balance at the end of the year $ 25,232 $ 18,355 $ 11,295
v3.24.0.1
Subsequent Events - Additional Information (Details) - USD ($)
$ in Thousands
2 Months Ended 12 Months Ended
Feb. 27, 2024
Dec. 31, 2023
Dec. 31, 2022
Subsequent Event [Line Items]      
Issuance of common stock under at-the-market offering, net of issuance costs, shares   101,637,922 94,833,975
Net proceeds of issuance of common stock   $ 164,233  
Subsequent Event | Amended ATM Facility [Member]      
Subsequent Event [Line Items]      
Issuance of common stock under at-the-market offering, net of issuance costs, shares 1,237,460    
Net proceeds of issuance of common stock $ 93,600