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SeaSpineUNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
________________________________________________________________________
FORM 10-K
 ________________________________________________________________________
(Mark One)
☒
ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
OR
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
☐
For the fiscal year ended December 31, 2021
For the transition period from                     to                    
Commission file number: 000-32259
________________________________________________________________________
ALIGN TECHNOLOGY, INC.
(Exact name of registrant as specified in its charter)
________________________________________________________________________
Delaware
(State or other jurisdiction of
incorporation or organization)
94-3267295
(I.R.S. Employer
Identification Number)
410 North Scottsdale Road, Suite 1300
Tempe, Arizona 85281
(Address of principal executive offices)
(602) 742-2000
(Registrant’s telephone number, including area code)
________________________________________________________________________
Title of each class
Common Stock, $0.0001 par value
Securities registered pursuant to Section 12(b) of the Act:
Trading Symbol
ALGN
Name of each exchange on which registered
The NASDAQ Stock Market LLC
(NASDAQ Global Market)
Indicate by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act.    Yes  ☒    No  ☐
Indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or Section 15(d) of the Exchange Act.    Yes  ☐    No  ☒
Securities registered pursuant to Section 12(g) of the Act: None
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or
for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.    Yes  ☒    No  ☐
Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this
chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).    Yes  ☒    No  ☐
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See
definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and "emerging growth company" in Rule 12b-2 of the Exchange Act. (Check one):
Large accelerated filer
Non-accelerated filer  
☒
☐
Accelerated filer  
Smaller reporting company  
Emerging growth company
☐
☐
☐
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting
standards provided pursuant to Section 7(a)(2)(B) of the Securities Act. ☐
Indicate by check mark whether the Registrant has filed a report on and attestation to its management’s assessment of the effectiveness of its internal control over financial reporting under
Section 404(b) of the Sarbanes-Oxley Act (15 U.S.C. 7262(b)) by the registered public accounting firm that prepared or issued its audit report. ☒
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).    Yes  ☐    No  ☒
The aggregate market value of the registrant’s common stock held by non-affiliates of the registrant was approximately $34.7 billion as of June 30, 2021 based on the closing sale price of
the registrant’s common stock on the NASDAQ Global Market on such date. Shares held by persons who may be deemed affiliates have been excluded. This determination of affiliate status is not
necessarily a conclusive determination for other purposes.
On February 21, 2022, 78,795,494 shares of the registrant’s common stock were outstanding.
DOCUMENTS INCORPORATED BY REFERENCE
Portions of the registrant’s definitive Proxy Statement relating to its 2022 Annual Stockholders’ Meeting to be filed pursuant to Regulation 14A within 120 days after the registrant’s fiscal
year end of December 31, 2021 are incorporated by reference into Part III of this Annual Report on Form 10-K.
ALIGN TECHNOLOGY, INC.
FORM 10-K
For the Year Ended December 31, 2021
TABLE OF CONTENTS
PART I  
Item 1.
Item 1A.
Item 1B.
Item 2.
Item 3.
Item 4.
PART II
Item 5.
Item 6.
Item 7.
Item 7A.
Item 8.
Item 9.
Item 9A.
Item 9B.
Item 9C.
PART III
Item 10.
Item 11.
Item 12.
Item 13.
Item 14.
PART IV
Item 15.
Item 16.
Signatures
Business
Information about our Executive Officers
Risk Factors
Unresolved Staff Comments
Properties
Legal Proceedings
Mine Safety Disclosures
Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities
[Reserved]
Management’s Discussion and Analysis of Financial Condition and Results of Operations
Quantitative and Qualitative Disclosures About Market Risk
Financial Statements and Supplementary Data
Changes in and Disagreements with Accountants on Accounting and Financial Disclosure
Controls and Procedures
Other Information
Disclosure Regarding Foreign Jurisdictions that Prevent Inspections
Directors, Executive Officers and Corporate Governance
Executive Compensation
Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters
Certain Relationships and Related Transactions and Director Independence
Principal Accountant Fees and Services
Exhibits and Financial Statement Schedules
Form 10-K Summary
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Invisalign,  Align,  the  Invisalign  logo,  ClinCheck,  Made  to  Move,  Invisalign  Assist,  Invisalign  Teen,  Invisalign  Go,  Vivera,  SmartForce,  SmartTrack,
SmartStage,  SmileView,  iTero,  iTero  Element,  Orthocad,  iCast,  iRecord  and  exocad,  among  others,  are  trademarks  and/or  service  marks  of  Align
Technology, Inc. or one of its subsidiaries or affiliated companies and may be registered in the United States and/or other countries.
2
 
 
 
In addition to historical information, this annual report on Form 10-K contains forward-looking statements within the meaning of Section 27A of the
Securities  Act  of  1933  and  Section  21E  of  the  Securities  Exchange  Act  of  1934.  These  statements  include,  among  other  things,  our  expectations  and
intentions  regarding  our  strategic  objectives  and  the  means  to  achieve  them,  our  estimates  regarding  the  size  and  opportunities  of  the  markets  we  are
targeting  along  with  our  expectations  for  growth  in  those  markets,  our  beliefs  regarding  the  impact  of  technological  innovation  in  general,  and  in  our
solutions and products in particular, on target markets and patient care, our beliefs regarding digital dentistry and its potential to impact our business, our
intentions  regarding  expanding  our  business,  including  its  impact  on  our  operational  flexibility  and  responsiveness  to  customer  demand,  our  beliefs
regarding the potential for clinical solutions and their utilization to increase sales of our Invisalign system as well as the complementary products and
solutions  themselves,  our  beliefs  regarding  doctor  training  and  its  impact  on  Invisalign  system  utilization,  our  beliefs  regarding  the  importance  of  our
manufacturing operations on our success, our beliefs regarding the need for and benefits of our technological development on Invisalign treatment, the
areas of development in which we focus our efforts, and the advantages of our intellectual property portfolio, our beliefs regarding our business strategy
and  growth  drivers,  our  expectations  regarding  product  mix  and  product  adoption,  our  expectations  regarding  the  utilization  rates  for  our  products,
including the impact of marketing on those rates and causes for periodic fluctuations of the rates, our expectations regarding the existence and impact of
seasonality  and  the  COVID-19  disruptions  to  seasonality,  our  expectations  regarding  the  sales  growth  of  our  intraoral  scanner  sales  in  international
markets, our expectations regarding the productivity impact additional sales representatives will have on our sales and the impact of specialization of those
representatives  in  sales  channels,  our  expectations  regarding  the  continued  expansion  of  our  international  markets  and  their  growth,  our  expectation
regarding customer and consumer purchasing behavior, including expectations related to the consumer demand environment in China especially for U.S.
based  products  and  services,  our  expectations  regarding  competition  and  our  ability  to  compete  in  our  target  markets,  our  beliefs  concerning  our
compliance  with  applicable  laws  and  regulations,  our  beliefs  regarding  our  culture  and  commitment  and  its  impact  on  our  financial  and  operational
performance and its importance to our future success, our expectations for future investments in and benefits from consumer demand sales and marketing
activities,  our  expectations  regarding  the  implications  of  the  COVID-19  pandemic  and  the  health,  safety  and  economic  impact  from  it,  on  the  global
economy, the businesses of our customers, and us, including our preparedness to react to changing circumstances and overall on our revenues, results of
operations and financial condition, our expectations for our expenses and capital obligations and expenditures in particular, the actions we will take to
control  spending  and  for  investments,  our  intentions  regarding  the  investment  of  our  international  earnings  from  operations,  our  belief  regarding  the
sufficiency  of  our  cash  balances  and  borrowing  capacity,  our  judgments  regarding  the  estimates  used  in  our  revenue  recognition,  and  assessment  of
goodwill and intangible assets, our expectations regarding our tax positions and the assumptions we make related to our tax obligations, our expectations
regarding potential additional litigation with SDC Financial LLC and certain affiliates, the level of our operating expenses and gross margin and other
factors beyond our control, as well as other statements regarding our future operations, financial condition and prospects and business strategies and any
other  statements  that  address  events  or  developments  that  we  intend  or  believe  will  or  may  occur  in  the  future.  Terminology  such  as  “believe,”
“anticipate,” “should,” “could,” “intend,” “will,” “plan,” “expect,” “estimate,” “project,” “target,” “may,” “possible,” “potential,” “forecast” and
“positioned” and similar references to future periods are intended to identify forward-looking statements, although not all forward-looking statements are
accompanied by such words. These or any forward-looking statements are subject to certain risks and uncertainties that could cause actual results to differ
materially from those reflected in the forward-looking statements. Factors that could cause or contribute to such differences include, but are not limited to,
those discussed in Part II, Item 7 “Management’s Discussion and Analysis of Financial Condition and Results of Operations,” and in particular, the risks
discussed below in Part I, Item 1A “Risk Factors.” We undertake no obligation to revise or update these forward-looking statements. Given these risks and
uncertainties, readers are cautioned not to place undue reliance on such forward-looking statements.
Item 1. Business.
Our Company
PART I
Align Technology, Inc. (“We”, “Our”, “Align”) is a global medical device company primarily engaged in the design, manufacture and marketing of
Invisalign®  clear  aligners,  iTero®  intraoral  scanners  and  services  for  dentistry,  and  exocad®  computer-aided  design  and  computer-aided  manufacturing
(“CAD/CAM”) software for dental laboratories and dental practitioners. We also market and sell consumer products that are complementary to our doctor-
prescribed principal products under the Invisalign and other brands, including retainers, aligner cases (clamshells), teeth whitening products and cleaning
solutions (crystals, foam and other material) (collectively “Consumer Products”). Our primary goals are to establish clear aligners as the principal solution
for the treatment of malocclusions, or the misalignment of teeth, and our Invisalign system as the treatment solution of choice by orthodontists, general
dental practitioners and patients globally, our intraoral scanners as the
3
 
preferred scanning technology for digital dental scans, and our exocad CAD/CAM software as the solution of choice for dental labs.
Align’s corporate headquarters are located at 410 North Scottsdale Road, Suite 1300, Tempe, Arizona 85281. Our telephone number is 602-742-2000.
Our internet address is www.aligntech.com. Our Americas regional headquarters is located in Raleigh, North Carolina, U.S.A.; our European, Middle East
and  Africa  (“EMEA”)  regional  headquarters  is  located  in  Rotkreuz,  Switzerland;  and  our  Asia  Pacific  (“APAC”)  regional  headquarters  is  located  in
Singapore.
We have two operating segments: (1) Clear Aligner and (2) Imaging Systems and CAD/CAM Services (“Systems and Services”). For the year ended
December  31,  2021,  Clear  Aligner  net  revenues  represented  approximately  82%  of  worldwide  net  revenues,  while  Systems  and  Services  net  revenues
represented  the  remaining  18%.  We  sell  the  majority  of  our  products  directly  through  a  dedicated  and  specialized  sales  force  to  our  customers:
orthodontists, general practitioner dentists (“GPs”), restorative and aesthetic dentists, including prosthodontists, periodontists, and oral surgeons, and dental
laboratories. We also sell through sales agents and distributors in certain countries. In addition, we sell directly to Dental Support Organizations (“DSOs”)
who contract with dental practices to provide critical business management and support including non-clinical operations, and we sell products used by
dental  laboratories  who  manufacture  or  customize  a  variety  of  products  used  by  licensed  dentists  to  provide  oral  health  care.  We  sell  our  Consumer
Products online through our corporate website and large e-commerce websites.
Our  clear  aligners  are  sold  under  the  Invisalign   brand  name.  Our  Invisalign  system  is  intended  mainly  for  the  treatment  of  malocclusions  and  is
designed  to  help  dental  professionals  achieve  the  clinical  outcomes  that  they  expect  and  the  results  patients  desire.  To  date,  over  12  million  people
worldwide  have  been  treated  with  our  Invisalign  system.  We  received  510(k)  clearance  from  the  United  States  (“U.S.”)  Food  and  Drug  Administration
(“FDA”) to market the Invisalign system in 1998. In order to provide Invisalign treatment to their patients, orthodontists and GPs must initially complete an
Invisalign training course.
®
Our iTero intraoral scanner is used by dental professionals and/or labs and service providers for restorative and orthodontic digital procedures as well
as  Invisalign  case  submissions.  To  date,  over  68,000  iTero  scanners  have  been  sold.  We  received  510(k)  clearance  in  the  U.S.  for  the  caries  detection
feature of the iTero Element 5D in 2020. Our Systems and Services products, which includes our iTero intraoral scanners, are primarily sold through our
direct sales force and through sales agents and distributors in certain countries and directly to DSOs.
Our  exocad  CAD/CAM  software  products  provide  restorative  dentistry,  implantology,  guided  surgery,  and  smile  design  to  dental  labs  and  dental
practices  through  fully  integrated  workflows,  paving  the  way  for  new,  cross-disciplinary  dentistry  in  labs  and  at  chairside.  There  are  over  200  exocad
strategic distribution partners and over 47,000 software licenses installed worldwide.
Clear Aligner Segment
Malocclusion and Traditional Orthodontic Treatment
Malocclusion  is  one  of  the  most  prevalent  clinical  dental  conditions,  affecting  approximately  60%  to  75%  of  the  global  population.  Annually,
approximately 21 million people globally elect treatment by orthodontists. Today, most orthodontic patients continue to have their malocclusions treated
with the use of traditional methods such as metal arch wires and brackets, referred to as braces, augmented with elastics, metal expanders, headgear or
functional appliances, and other ancillary devices as needed. Upon completion of the treatment, the dental professional may recommend the patient use a
retainer  appliance.  Of  the  21  million  cases  started,  we  estimate  that  approximately  90%  or  19  million  could  be  treated  using  our  Invisalign  system.  In
addition,  globally  approximately  500  million  people  with  malocclusion  could  benefit  from  straightening  their  teeth.  This  represents  a  significant
opportunity for us as we expand the market for orthodontics by training more doctors, including GPs as well as orthodontists, educating more consumers
about the benefits of straighter teeth using the Invisalign system and connecting consumers with an Invisalign-trained doctor of their choice.
The Invisalign system
The Invisalign system is a proprietary method for treating malocclusion based on a proprietary computer-simulated virtual treatment plan and a series
of  doctor-prescribed,  custom  manufactured,  clear  polymer  removable  aligners.  The  Invisalign  system  offers  a  range  of  treatment  options,  specialized
services, and access to proprietary software for treatment visualization and is comprised of the following phases:
4
Diagnosis and transmission of treatment data. An Invisalign trained dental professional prepares an online prescription form on our Invisalign Doctor
Site  and  submits  the  patient's  records,  which  include  a  digital  intraoral  scan  or  a  polyvinyl-siloxane  (“PVS”)  impression  of  the  relevant  dental  arches,
photographs  of  the  patient  and,  at  the  dental  professional’s  election,  x-rays  of  the  patient’s  dentition.  Intraoral  digital  scans  may  be  submitted  through
Align’s  iTero  scanner  or  certain  third-party  scanners  capable  of  accurately  interfacing  with  our  systems  and  processes.  Globally,  more  than  85%  of
Invisalign  system  case  submissions  are  now  submitted  via  digital  scan,  increasing  the  accuracy  of  treatments,  reducing  the  time  from  prescription
submission to patient receipt, and decreasing the carbon footprint resulting from the shipment of the materials used to form PVS impressions to the doctors
and shipping those PVS impressions back to us. Additionally, it is during this stage that exocad’s CAD/CAM software platform can be used to identify,
assess  and  assist  doctors  and  dental  labs  to  collaborate  on  any  needed  ortho-restorative  treatment  options  through  comprehensive  interdisciplinary
workflows.
Computer-simulated treatment plan. Using the digital scans or PVS impressions, certain doctor preferences and digital data provided, we generate a
proposed custom, three-dimensional treatment plan, called a ClinCheck treatment plan using proprietary software we have developed through significant,
ongoing investments over more than 20 years. A patient’s ClinCheck treatment plan simulates desired tooth movement in stages and details the timing and
placement  of  any  features  or  attachments  to  be  used  during  treatment. Attachments  are  tooth-colored  “buttons”  that  are  sometimes  used  to  increase  the
biomechanical force on a specific tooth or teeth in order to affect the desired movement(s).
® 
Review  and  approval  of  the  treatment  plan  by  an  Invisalign  trained  doctor.  The  patient’s  ClinCheck  treatment  plan  is  then  made  available  to  the
prescribing  dental  professional  via  Align’s  Invisalign  Doctor  Site,  enabling  the  dental  professional  to  evaluate  projected  tooth  movement  from  initial
position to final position and compare multiple treatment plan options. By reviewing, modifying as needed and approving the treatment plan, the dental
professional retains control of the patient’s treatment.
Manufacture  of  custom  aligners.  Following  the  dental  professional’s  approval  of  a  ClinCheck  treatment  plan,  we  use  the  data  underlying  the
simulation  as  input  for  the  next  stage  in  which  we  use  stereolithography  technology  (a  form  of  3D  printing  technology)  to  construct  a  series  of  molds
depicting the future position of the patient’s teeth. Each mold is a replica of the patient’s teeth at each stage of the simulated course of treatment. From
these molds, aligners are fabricated by pressure-forming polymeric sheets over each mold. Aligners are thin, clear polymer, removable dental appliances
that are custom manufactured in a series designed to correspond to each stage of the patient's ClinCheck treatment plan.
Shipment to the dental professional and patient aligner wear. Once manufactured, all the aligners for a patient's doctor-approved treatment plan are
typically shipped directly to the dental professional, who then dispenses them to the patient at regular check-up intervals. Aligners are generally worn for a
short period of time corresponding to the stages of the patient’s approved ClinCheck treatment plan and their doctor’s discretion. The patient replaces the
aligners with the next pair in the series when prescribed, advancing tooth movement through each stage. At various points in each patient’s treatment, their
doctor  may  place  attachments  or  use  other  auxiliaries  to  achieve  desired  tooth  movements,  per  the  doctor’s  original  prescription  and  the  approved
ClinCheck treatment plan. Additionally, for patients treated using many of our Invisalign system treatments, doctors have the option to adjust treatment
plans to achieve desired results by ordering additional clear aligners in accordance with pre-defined terms.
Clear Aligner Products
We offer our Invisalign system in a variety of treatment packages designed to correspond with the case-by-case treatment needs of our doctors and
their  patients.  The  table  below  provides  a  general  description  of  the  categories  of  treatment  products  we  offer  in  various  regions  as  they  typically
correspond to the severity of malocclusion and length of anticipated treatment.
5
Malocclusion
Very Mild
Product
Invisalign Express Package
Invisalign Lite Package
Moderate
Invisalign Go Limited
Movement (GP)
Treatment Stages*
7
14
20
Clinical Scope
Relapse and minor
movement, anterior esthetic
alignment
Class I, mild
crowding/spacing, non-
extraction, pre-restorative
* The number of stages can vary by product and region.
Class I, no anterior /
posterior correction, mild to
moderate crowding,
spacing, non-extraction,
pre-restorative Tooth
movement from 2nd
premolar to 2nd premolar
(5x5)
Invisalign Moderate
Packages (& Invisalign Go
Plus)
20-26
Class I, mild Class II, mild
to moderate
crowding/spacing, mild
anterior / posterior and
vertical discrepancies, pre-
restorative, (Go Plus tooth
movement from 1  molar to
st
1  molar (6X6))
st
Severe
Invisalign Comprehensive
Packages
As many as required
Class I, II, III, moderate to
severe crowding/spacing,
anterior / posterior and
vertical discrepancies,
extractions, complex pre-
restorative
Most of our Invisalign system treatment plans described above provide dental professionals with the option to order additional aligners if the patient's
treatment deviates from the original treatment plan. The number and timing of additional aligner orders are subject to certain requirements noted in our
terms and conditions.
Comprehensive Products - Invisalign Treatment Options:
Invisalign Comprehensive Packages. The Invisalign Comprehensive Package is used to treat adults and teens over a wide spectrum of mild to severe
malocclusion and contains a broad variety of Invisalign features to address the desired treatment goals. It also addresses the frequently complex orthodontic
needs of teenage or younger patients with advanced features such as mandibular advancement, compliance indicators and compensation for tooth eruption.
These packages include Invisalign Comprehensive, Invisalign First Phase 1 and Invisalign First Comprehensive Phase 2.  
Invisalign First Phase 1 and Invisalign First Comprehensive Phase 2 Packages. Invisalign First Phase 1 Package is designed specifically for younger
patients generally between the ages of seven and ten years, who frequently have a mixture of primary/baby and permanent teeth. Invisalign First Phase 1
treatment provides early interceptive orthodontic treatment, traditionally done through arch expansion, or partial metal braces, before all permanent teeth
have erupted. Invisalign First Phase 1 clear aligners are designed specifically to address a wide range of younger patients' malocclusions, including shorter
clinical  crowns,  management  of  erupting  dentition  and  predictable  dental  arch  expansion.  Our  Invisalign  First  Comprehensive  Phase  2  Package  is
complementary to Invisalign First Phase 1 and is generally consistent with our Invisalign Comprehensive Package. After a patient completes Invisalign
First Phase 1, doctors have the option to purchase a Comprehensive Phase 2 Package for that same patient.
Non-Comprehensive Products - Invisalign Treatment Options:
Invisalign  Non-comprehensive  Packages.  We  offer  a  variety  of  lower  priced  treatment  packages  for  less  complex  orthodontic  cases,  non-
comprehensive  relapse  cases,  or  straightening  prior  to  restorative  or  cosmetic  treatments,  such  as  veneers.  These  treatment  packages  include  Invisalign
Express, Lite, Go, Go Plus and Moderate. These packages may be offered in select countries and/or may differ from region to region.
Invisalign Go Packages. We also offer in various markets Invisalign Go and Invisalign Go Plus, streamlined Non-Comprehensive packages designed
for  GPs  to  more  easily  identify  and  treat  patients  with  mild  malocclusion.  The  Invisalign  Go  and  Invisalign  Go  Plus  packages  include  case  assessment
support, simplified ClinCheck treatment plans and a progress assessment feature for case monitoring.
Feature Enhancement / New Products
Invisalign  G8  with  SmartForce®  Activation.  Broadly  released  in  early  2021,  Invisalign  G8  with  SmartForce  Aligner  Activation  is  a  clear  aligner
biomechanical innovation designed to optimize tooth movements and further improve predictability for frequently treated crowding, crossbite, and deep
bite cases through the targeted application of force to teeth through surface contours on the aligners that help control the location, direction and intensity of
tooth movement.
6
New Invisalign Innovations in Treatment Planning for Align Digital Platform. Released in early 2022, the new Invisalign system innovations as a part
of the Align digital platform is a combination of software, systems and services designed to provide a seamless experience and workflow that integrates
and  connects  all  users  –  doctors,  labs,  patients  and  consumers.  These  new  innovations  include  ClinCheck  Live  Update  for  3D  controls,  the  Invisalign
Practice App, Invisalign Personalized Plan and Invisalign Smile Architect.
Non-Case Products:
Clear  Aligner  non-case  products  include  retention  products,  Invisalign  training,  adjusting  tools  used  by  dental  professionals  during  the  course  of
treatment and ancillary Consumer Products and other oral health products available in certain e-commerce channels in the U.S.
Retention. We offer up to four sets of custom clear aligners called Vivera retainers made with proprietary material strong enough to maintain tooth
position and correct minor relapse, if necessary, as well as Invisalign retainers. Retainers are generally available for doctors to offer to any of their patients,
whether they use the Invisalign system or other products, including wires and brackets. In select markets, we also offer single set retainers. Further, in the
third  quarter  of  2021,  we  announced  a  multi-year  supply  and  distribution  agreement  with  Ultradent  Products  to  allow  Invisalign  trained  doctors  to
exclusively offer a professional whitening system using Ultradent’s Opalescence PF whitening system with Vivera retainers.
We also offer in the U.S., a Doctor Subscription Program which is a monthly subscription program based on the doctor’s monthly need for retention
or limited treatment. The program allows doctors the flexibility to order both “touch-up” or retention aligners within their subscribed tier and is designed
for a segment of experienced Invisalign doctors who are currently not regularly using our retainers or low-stage aligners.
SmartTrack Aligner Material:
SmartTrack  clear  aligner  material  is  a  patented,  custom-engineered  Invisalign  clear  aligner  material  that  delivers  gentle,  more  constant  force
considered ideal for orthodontic tooth movements. Conventional aligner materials relax and lose a substantial percent of the force applied in the initial days
of  wear.  SmartTrack  material  maintains  more  constant  force  over  time.  The  flexible  SmartTrack  material  also  more  precisely  conforms  to  tooth
morphology, attachments and interproximal spaces to improve control of tooth movement throughout treatment.
Systems and Services Segment
Intraoral scanning is a rapidly evolving technology that is having a substantial impact on the practice of dentistry. By enabling the dental practitioner
to create a 3D image of a patient's teeth (digital scan) using a handheld intraoral scanner, digital scanning is faster, more efficient, precise and comfortable
for patients. Beginning patient care with the early usage of our iTero intraoral scanners and combining the results with digital workflows designed to assist
doctors and patients visualize and evaluate various treatment options with detailed imagery and CAD/CAM solutions is helping patients decide to undergo
treatment  and  improve  treatments,  outcomes  and  satisfaction.  The  accuracy  of  digitally  scanned  models  substantially  reduces  the  rate  of  restoration
"remakes," meaning patients are recalled less often and the appointment time for the restoration is shorter because of fewer adjustments, increasing overall
patient  satisfaction.  Digital  models  also  reduce  the  carbon  footprint  associated  with  the  shipping  of  the  materials  used  to  create  PVS  impressions,  the
shipping of those impressions and their disposal. Moreover, the digital model file can be used for various procedures and services including fabrication of
physical dental models for use by labs to create restorative units such as veneers, inlays, onlays, crowns, bridges and implant abutments; digital records
storage; aid to caries detection; orthodontic diagnosis; orthodontic retainers and appliances; and Invisalign digital impression submission.
iTero Scanner. The iTero Element portfolio of intraoral scanners includes the iTero Element 2, the iTero Element Flex, iTero Element 5D Imaging
System and iTero Element Plus Series which are each available in select regions and countries. These products build on the existing high precision, full-
color imaging and fast scan times of the iTero Element portfolio and are available with software options for orthodontic and restorative procedures. The
iTero scanner is interoperable with our Invisalign treatment such that a full arch or full mouth digital scan can be submitted as part of the Invisalign system
case submission process.
Our iTero Element 5D imaging system is the first integrated dental imaging system that simultaneously records 3D, intraoral color camera images and
near  imaging  (“NIRI”)  technology  and  enables  comparison  over  time  using  the  iTero  TimeLapse  technology.  NIRI  technology,  included  in  our  iTero
Element  5D  and  5D  Plus  Imaging  Systems,  aids  in  detection  and  monitoring  of  interproximal  caries  lesions  above  the  gingiva  without  using  harmful
radiation.  The  iTero  Element  5D  Imaging  System  is  available  in  the  U.S.,  Canada,  China,  and  the  majority  of  EMEA  and  select  APAC  and  LATAM
countries
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and is pending regulatory approval in others.
The  iTero  Element  Plus  Series  of  intraoral  scanners  and  imaging  systems  was  introduced  in  the  first  quarter  of  2021  and  offers  restorative  and
orthodontic  digital  workflows  that  include  enhanced  visualization  for  optimized  patient  experience,  including  a  fully  integrated  3D  intraoral  camera  in
certain models,; seamless scanning with reduced processing time, artificial intelligence-based features, and, in certain models, NIRI technology.
Services and Ancillary Products. Our services include subscription software, disposables, rentals, and pay per scan as well as exocad’s CAD/CAM
software solutions that integrate workflows to dental labs and dental practices.
Restorative software for iTero scanners and imaging systems. Our Restorative software is designed for GPs, prosthodontists, periodontists and oral
surgeons and includes restorative workflows providing the ability to send digital impressions to the lab of their choice and communicate seamlessly with
external treatment planning, custom implant abutment, chairside milling and laboratory CAD/CAM systems such as through our exocad Connector. iTero
intraoral scans can enhance the accuracy and precision of a doctor’s downstream restorative process.
Orthodontic software for iTero scanners and imaging systems. Our iTero software is designed for orthodontists for digital records storage, orthodontic
diagnosis, and for the fabrication of printed models and retainers. 
CAD/CAM Services. Our exocad CAD/CAM software platform addresses restorative needs in an end-to-end digital platform workflow to facilitate
ortho-restorative and comprehensive dentistry. The platform provides doctors and dental labs with digital clinical solutions that aid general dentists and
dental labs in planning and delivering restorative dental treatments, adding restorative functionality to our comprehensive digital platform to deliver digital
ortho-restorative workflows and interdisciplinary dentistry. Our exocad software is licensed and sold separately.
Ancillary Products. We sell disposable sleeves for the wand and other ancillary products for the iTero scanner.
iTero Models and Dies. An accurate physical model and dies are manufactured based on the digital scan and sent to the laboratory of the dentist’s
choice for completion of the needed restoration. The laboratory also has the option to export the digital file for immediate production of coping and full-
contour restorations on their laboratory CAD/CAM systems. The laboratory then completes the ceramic buildup or staining and glazing and delivers the
end result - a precisely fitting restoration.
Third-Party Scanners and Digital scans. We accept case submissions for our clear aligner products in two ways: (1) PVS impressions of patients’
teeth or (2) intraoral scans of their teeth. With respect to intraoral scans, we accept scans from iTero scanners and certain third-party scanners that have an
interoperability relationship with our systems and processes.
iTero Applications and Tools
Invisalign Outcome Simulator. The Invisalign Outcome Simulator is an exclusive chair-side and cloud-based application for the iTero scanner that
allows doctors to help patients visualize how their teeth may look at the end of Invisalign treatment. This is achieved through a dual view layout that shows
a prospective patient an image of their own current dentition next to a simulated final position after Invisalign treatment.
Invisalign Progress Assessment Tool. The Invisalign Progress Assessment tool provides the ability to compare a patient’s new scan with a specific
stage of their ClinCheck treatment plan, allowing doctors to visually assess and communicate Invisalign treatment progress with an easy to read, color-
coded tooth movement report.
TimeLapse Technology. Our  TimeLapse  technology  allows  doctors  or  practitioners  to  compare  a  patient’s  historic  3D  scans  to  a  present-day  scan,
enabling clinicians to identify and measure orthodontic movement, tooth wear, and gingival recession. This highlights areas of diagnostic interest to dental
professionals and helps foster a proactive conversation with the patient regarding potential restorative or orthodontic solutions.
Our  iTero  Element  scanners  are  offered  in  a  number  of  software  configurations  such  as  Ortho  Comprehensive,  Restorative  Comprehensive  and
Restorative Foundation. These software packages are included in the price of the scanner and have a service period of 1 to 5 years. They enable various
orthodontic  and  restorative  workflows  as  well  as  provide  other  applications,  including  Invisalign  Outcome  Simulator,  Invisalign  Case  Assessment  tool,
Invisalign  Progress  Assessment  tool,  and  iTero  TimeLapse  technology.  We  also  recently  introduced  our  5D  Photo  uploader  enhanced  workflow  that
simplifies the process for submitting images needed for treatment planning.
Other proprietary software mentioned in this Annual Report on Form 10-K, such as software embedded in our iTero
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scanners, ClinCheck and ClinCheck Pro software, the Invisalign Doctor Site, and feature enhancements included as part of the Invisalign system are not
sold separately, nor do they contribute as individual items to revenues.
Business Strategy
Our technology and innovations are designed to meet the demands of today’s patients with treatment options that are convenient, comfortable, and
affordable, while helping to improve overall oral health. We strive to help doctors and lab technicians move their businesses forward by connecting them
with  new  patients,  providing  digital  solutions  that  increase  operational  speed  and  efficiency  and  provide  solutions  that  allow  them  to  deliver  the  best
possible treatment outcomes and experiences to millions of people around the world. We achieve this by focusing on and executing to our strategic growth
drivers:
•
International Expansion. We continue increasing our presence globally by making our products available in more countries to more customers. In
2021,  the  number  of  international  doctors  trained  to  prescribe  treatment  using  the  Invisalign  system  grew  by  approximately  21%  compared  to
2020. We continue expansion of our sales and marketing by reaching into new countries and regions, including new areas within Africa. By the
end of 2021, we were selling directly or through authorized distributors in more than 100 countries. As our business continues to grow in both
number  of  new  Invisalign  trained  doctors  and  customer  utilization,  we  support  that  growth  through  targeted  investments  such  as  increasing
headcount, clinical support, product improvements, technological innovations, clinical education and advertising. In addition, we are scaling and
expanding  our  operations  and  facilities  to  better  support  the  growing  numbers  of  global  customers.  For  instance,  for  China  and  other  APAC
markets,  we  now  primarily  fabricate  our  clear  aligners  in  Ziyang,  China,  and  we  perform  digital  treatment  planning  and  interpretation  for
restorative cases worldwide, including in Costa Rica, China, Germany, Spain, Poland, and Japan, among others. In 2021, we announced similar
plans to open a clear aligner manufacturing facility in Wroclaw, Poland. Expected to begin serving doctors during the first half of 2022, the new
manufacturing  facility  will  be  our  third  aligner  fabrication  facility  and  allow  us  to  more  quickly  and  effectively  serve  tens  of  thousands  of
customers throughout EMEA. By establishing and expanding our key operational activities in locations closer to our customers, we are creating an
infrastructure  that  allows  us  to  be  responsive  to  local  and  regional  needs,  while  providing  global  operational  flexibility  and  scale  needed  for
variations  in  global  and  regional  demand.  We  expect  to  continue  expanding  our  business  in  2022  by  investing  in  resources,  infrastructure  and
initiatives that help drive Invisalign treatment growth, our intraoral scanners as the preferred scanning technology for digital dental scans, and our
exocad CAD/CAM software as the solution of choice for dental labs in existing and new international markets.
• GP  Adoption.  We  want  to  enable  GPs,  who  have  access  to  a  large  patient  base,  to  more  easily  identify  potential  cases  they  can  treat  with  the
Invisalign system, monitor patient progress or, if needed, help refer cases to an orthodontist while providing high-quality restorative, orthodontic
and dental hygiene care. We believe success with GPs can be achieved through doctor training and clinical education, by offering digital tools
such as the iTero scanner and products like Invisalign Go treatment that address the distinctive needs of GP patients, all delivered by sales and
marketing personnel specifically focused on the unique needs of this customer category. We encourage GPs to scan every patient with intraoral
scanners that are without harmful radiation as a means to diagnose and treat patients over time and as an opportunity to drive future demand for
their  services  and  the  Invisalign  system.  To  support  our  belief  in  the  benefits  of  using  our  iTero  scanners,  in  October  2021  we  announced  the
findings  of  a  clinical  study  that  validates  and  demonstrates  that  the  NIRI  technology  of  the  iTero  Element  5D  imaging  system  was  66%  more
sensitive than bitewing x-ray radiography for detection of interproximal lesions, without the use of harmful radiation.
•
Patient Demand & Conversion. Our goal is to make the Invisalign brand a highly recognized name brand worldwide by creating awareness for
Invisalign treatment among consumers and motivating the potential 500 million patients who can benefit from treatment of malocclusion to seek
treatment  using  the  Invisalign  system.  We  accomplish  this  through  an  integrated  consumer  marketing  strategy  that  includes  television,  media,
social networking and event marketing and strategic alliances with professional sports teams, as well as educating patients on treatment options
and  directing  them  to  high  volume  Invisalign  trained  doctors.  We  further  support  our  doctor  customers  as  they  adopt  digital  dentistry  through
programs such as the Align Digital and Practice Transformation (“ADAPT”). ADAPT is an expert and independent fee-based business consulting
service designed to optimize dental operational workflow and processes to enhance patients' experiences and customer and staff satisfaction with
the goal of increasing practice growth and efficiencies. To further drive consumer awareness, in 2021 we began offering additional dental-related
Consumer Products under the Invisalign brand name available in certain e-commerce channels in the U.S.
• Orthodontist Utilization.  We  continue  to  innovate  and  increase  product  applicability  and  predictability  to  address  a  wide  range  of  cases,  from
simple to complex, thereby enabling doctors to confidently diagnose and treat children and
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adults with the Invisalign system. This is especially important to treating teenage patients who make up the largest portion of the 21 million annual
orthodontic case starts each year. We also continue to make improvements to our Invisalign treatment software, ClinCheck Pro software, designed
to deliver an exceptional user experience and increase treatment control to help our doctors achieve their treatment goals. In combination with the
new  Invisalign  system  innovations  that  are  part  of  the  Align  digital  platform,  we  are  enhancing  the  digital  treatment  planning  experience  for
orthodontics and restorative dentistry by providing doctors with greater flexibility, consistency of treatment preferences and real-time treatment
plan access and modification capabilities.
Manufacturing and Suppliers
We  have  manufacturing  facilities  located  in  Juarez,  Mexico,  where  we  conduct  our  aligner  fabrication,  distribution,  and  certain  services  and  in
Ziyang, China, where we fabricate aligners primarily for China and other APAC markets. In addition, we produce our handheld intraoral scanner wand,
perform final scanner assembly and repair our scanners at our facilities in Ziyang, China and Or Yehuda, Israel and service and repair certain scanners in
Juarez, Mexico. In the second quarter of 2021, we announced the start of a multi-million dollar project to bring operational facilities closer to our customers
through the expansion of our manufacturing operations in Wroclaw, Poland. Expected to begin serving doctors during the first half of 2022, the new aligner
fabrication facility will be our third and allow us to more quickly and effectively serve tens of thousands of customers throughout EMEA. Additionally, in
the third quarter of 2021, we opened our multi-story iTero scanner and services facilities in Petach Tikva, Israel to further the design and development of
our portfolio of iTero intraoral scanners, imaging systems and services.
We also perform digital treatment planning and interpretation for restorative cases based on digital scans generated by our iTero intraoral scanners.
Our  digital  treatment  planning  facilities  are  located  worldwide,  including  in  Costa  Rica,  China,  Germany,  Spain,  Poland  and  Japan,  among  other
international locations.
Our quality system is required to be in compliance with the Quality System regulations enforced by the FDA, and similar regulations enforced by
other  worldwide  regulatory  authorities.  We  are  certified  to  ISO  13485:2016,  an  internationally  recognized  standard  for  medical  device  quality.  We  are
routinely audited by third party certification bodies as well as global health authorities for our compliance to this quality standard as well as international
regulations.  We  have  a  formal,  documented  quality  system  by  which  quality  objectives  are  defined,  understood  and  achieved.  Systems,  processes  and
procedures are implemented to ensure high levels of product and service quality. We monitor the effectiveness of the quality system based on internal data
and direct customer feedback and strive to continually improve our systems and processes, taking corrective action, as needed.
Since the manufacturing process of our products requires substantial and varied technical expertise, we believe that our manufacturing capacity and
capabilities are important to our success. In order to produce our highly customized, highly precise, medical quality products in volume, we have developed
a  number  of  proprietary  processes  and  technologies.  These  technologies  include  complex  software  algorithms  and  solutions,  CT  scanning,
stereolithography  and  automated  aligner  fabrication.  To  increase  the  efficiency  of  our  manufacturing  processes,  we  continue  to  focus  our  efforts  on
software  development  and  the  improvement  of  rate-limiting  processes  or  bottlenecks.  We  continuously  upgrade  our  proprietary,  three-dimensional
treatment planning software to enhance computer analysis of treatment data and to reduce time spent on manual and judgmental tasks for each case, thereby
increasing  the  efficiency  of  our  technicians.  In  addition,  to  improve  efficiency  and  increase  the  scale  of  our  operations,  we  continue  to  invest  in  the
development of automated systems for the fabrication and packaging of aligners.
We are highly dependent on manufacturers of specialized scanning equipment, rapid prototyping machines, resin and other advanced materials for our
aligners, as well as the optics, electronic and other mechanical components of our intraoral scanners. We maintain single supplier relationships for many of
these machines and materials technologies. In particular, our CT scanning and stereolithography equipment used in our aligner manufacturing and many of
the critical components for the optics of our intraoral scanners are provided by single or sole source suppliers. We also currently purchase our resin and
polymer, the primary raw materials used in our manufacturing process for clear aligners, from a single source. A discussion of the risks of our supply and
manufacturing operations, including foreign operations, may be found in Item 1A of this Annual Report on Form 10-K under the heading "Risk Factors."
Sales and Marketing
Our sales and marketing efforts are focused on increasing adoption and utilization of the Invisalign system and Vivera retainers by orthodontists and
GPs worldwide and integrating the iTero scanner and exocad CAD/CAM products into dental labs and practices. The scanner is an important component to
the customer experience and is central to a digital approach as well as overall customer utilization of Invisalign treatments. In each region, we have direct
sales, marketing and support
10
organizations, which include quota carrying sales representatives, sales management and sales administration. We also have distribution partners in certain
markets. Our sales and marketing personnel are organized to support orthodontists and GPs separately, allowing highly trained and specialized personnel to
serve  each  customer  category,  thereby  increasing  our  focus  and  effectiveness  on  both.  We  continue  to  expand  in  existing  markets  through  targeted
investments  in  sales  resources,  professional  marketing  and  education  programs.  Additionally,  our  consumer  marketing  programs  are  designed  to  create
awareness and educate consumers on the benefits of Invisalign treatment and Vivera retainers, including where they can find a trained doctor to provide
treatment.
We  provide  training,  marketing  and  clinical  support  to  orthodontists  and  GPs. As  of  December  31,  2021,  we  had  approximately  122,500  active
Invisalign trained doctors. We define doctors as active if they have submitted at least one case in the prior 12-month period.
Research and Development
We are committed to investing in world-class digital technology development, which we believe is critical to achieving our goal of establishing the
Invisalign system as the standard method for treating malocclusion, our intraoral scanners as the preferred scanning technology for digital dental scans, and
our exocad CAD/CAM software as the solution of choice for dental labs.
Our  research  and  development  activities  are  directed  toward  developing  digital  technology  innovations  that  we  believe  will  deliver  our  next
generation  of  products  and  solutions  to  enable  the  Align  digital  platform.  These  activities  range  from  accelerating  product  and  clinical  innovation  to
developing manufacturing process improvements to researching future technologies, products and software.
In an effort to demonstrate the broad treatment capabilities of the Invisalign system, various clinical case studies and articles have been published that
highlight the clinical applicability of Invisalign treatment to malocclusion cases, including those of severe complexity. Similarly, various studies have also
been  published  demonstrating  the  capabilities  of  our  scanners,  including  advanced  features  such  as  our  NIRI  technology.  We  undertake  pre-
commercialization trials and testing of our technological improvements to our products and manufacturing process. We furthermore fund research in the
field of orthodontics and dentistry through initiatives such as our Annual Research Award Program, which was in its 12th year in 2021, our donations to the
American  Association  of  Orthodontists  Foundation  and  our  partnership  with  MedTech  Innovator  Asia  Pacific,  a  nonprofit  startup  accelerator  for  the
medical technology industry that connects healthcare industry leaders with innovative medical technology startups for mentorship and support.
Intellectual Property
We believe our intellectual property portfolio represents a substantial business advantage. As of December 31, 2021, we had 642 active U.S. patents,
724 active foreign patents, and 736 pending global patent applications. Our active U.S. patents expire between 2022 and 2040. When patents expire, we
lose the protection and competitive advantages they provided, which could negatively impact our operating results; however, as we continue to pursue new
innovations, we seek intellectual property protection for new inventions and know-how through U.S. and foreign patent applications and non-disclosure
agreements. We also seek to protect our software, documentation and other written materials under trade secret and copyright laws. We furthermore have a
broad and diverse trademark portfolio that we use to highlight and protect our universally recognized brands. Information regarding risks associated with
our  proprietary  technology  and  our  intellectual  property  rights  may  be  found  in  Item 1A of  this  Annual  Report  on  Form  10-K  under  the  heading  “Risk
Factors.”
Seasonal Fluctuations
General economic conditions impact our business and financial results, and we have historically experienced seasonal trends within our two operating
segments, customer channels and the geographic locations that we serve. Sales of the Invisalign system are often weaker in Europe, especially southern
European countries during the summer months due to our customers and their patients being on holiday and seasonally higher in China during the third
quarter.  Similarly,  other  international  holidays  like  Lunar  New  Year  can  impact  our  sales  in  APAC.  In  North  America,  summer  is  typically  the  busiest
season for orthodontists with practices that have a high percentage of adolescent and teenage patients as many parents want to get their teenagers started in
treatment before the start of the school year; however, many GPs are on vacation during this time and therefore tend to start fewer cases. For our Systems
and Services segment, capital equipment sales are often stronger in the fourth calendar quarter. Consequently, these seasonal trends have caused and may
continue to cause fluctuations in our quarterly results, including fluctuations in sequential revenue growth rates. Moreover, the COVID-19 pandemic with
its consequent office closures or capacity constraints imposed to curtail the spread of the virus and its variants, and the easing and
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reimplementation  of  those  restrictions,  has  exacerbated  the  timing  and  extent  of  seasonal  patterns  and  it  remains  unclear  when  or  if  they  will  return  to
historical norms.
Competition
Our clear aligner products compete directly against traditional orthodontic treatments that use metal brackets and wires and increasingly against clear
aligner  products  manufactured  and  distributed  by  various  companies,  both  within  and  outside  the  U.S.  Although  the  number  of  competitors  varies  by
segment,  product,  geography  and  customer,  they  include  new  and  well-established  regional  competitors  in  certain  foreign  markets,  as  well  as  larger
companies or divisions of larger companies with substantial sales, marketing, research and financial capabilities. Due in part to the expiration of certain of
our clear aligner key patents beginning in 2017 and the significant benefits of clear aligner treatment over traditional brackets and wires, competition in the
clear  aligner  market  is  increasing.  In  addition,  corresponding  foreign  patents  began  expiring  in  2018  which  has  increased  competition  outside  the  U.S.
These  competitors  include  existing  larger  companies  in  certain  markets  who  have  the  ability  to  leverage  their  existing  channels  in  the  dental  market  to
compete directly with us, direct-to-consumer (“DTC”) companies that provide clear aligners requiring little or no in-office care from trained and licensed
doctors, and doctors themselves who can manufacture custom aligners in their offices using modern 3D printing technology. Unlike our DTC competitors,
we are committed to doctors being at the core of our business strategy, and Invisalign treatment requires a doctor's prescription and an in-person physical
examination of the patient’s dentition before treatment can begin.
Additionally, we face competition in the emerging and rapidly evolving markets for intraoral scanners and software solutions, including CAD/CAM.
The global intraoral scanner market is very dynamic with participants spanning from traditional dental conglomerates to companies dedicated primarily to
scanner development and sales with new entrants from South Korea and China playing larger roles. Information regarding risks associated with increased
competition may be found in Item 1A of this Annual Report on Form 10-K under the heading “Risk Factors.”
We believe we are well positioned to compete in the markets we target. We have a dedicated sales force of over 4,000 employees who are focused on
key demographics in our target markets that allow us to uniquely address customer needs and thereby enhance the customer experience. Our significant
historical and ongoing investments in research and design around the movement of teeth, SmartTrack aligner materials and design, intraoral scanning, 3D
manufacturing,  global  scale  of  manufacturing  and  treatment  planning,  strong  brand  name  recognition,  and  an  in  depth  understanding  of  the  drivers  and
motivations within the orthodontic and GP dental markets are among a few of our key competitive factors that compare favorably with our competitors’
products and services.
Government Regulation
Many countries throughout the world have established regulatory frameworks for commercialization of medical devices. As a designer, manufacturer,
and  marketer  of  medical  devices,  we  are  obligated  to  comply  with  the  respective  frameworks  of  these  countries  to  obtain  and  maintain  access  to  these
global markets. The frameworks often define requirements for marketing authorizations which vary by country. Failure to obtain appropriate marketing
authorization and to meet all local requirements, including specific quality and safety standards in any country in which we currently market our products,
could cause commercial disruption and/or subject us to sanctions and fines. Delays in receipt of, or a failure to receive, such marketing authorizations, or
the loss of any previously received authorizations, could have a material adverse effect on our business, financial condition and results of operations.
With regards to premarket authorization in the U.S., many of our products are classified as medical devices under the U.S. Food, Drug, and Cosmetic
Act  (“FD&C  Act”).  The  FD&C  Act  requires  these  products,  when  sold  in  the  U.S.,  to  be  safe  and  effective  for  their  intended  use  and  to  comply  with
medical device regulations defined by the FDA. The regulatory framework depends on a set of written processes for ensuring consistent quality called a
Quality  Management  System  (“QMS”)  coupled  with  a  product  marketing  authorization  which  depends  on  the  risk  classification  of  the  product.  This
regulatory  framework  is  comparable  to  the  framework  established  in  the  European  Union  (“EU”).  Within  the  EU,  our  products  are  subject  to  the
requirements defined by the Medical Device Regulation EU 2017/745 which replaced the Medical Device Directive 93/42/EEC with a final transition date
of May 26, 2021. Similar market access regulations exist in Brazil, China, Japan and other countries. Our QMS is routinely audited by certification bodies
as  well  as  country  regulators  for  compliance  with  applicable  regulations.  We  believe  we  are  in  compliance  with  all  state,  federal,  and  international
regulatory requirements applicable to our products.
We are also subject to various laws around the world that govern interactions with our customers as healthcare professionals or government officials.
The laws govern different interactions and may include prohibiting improper influence of or payments to healthcare professionals and government officials,
setting out rules for when and how to engage healthcare professionals as our vendors, requiring price reporting regulations, requiring proper and on label
promotion, sale and marketing
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of our products and services, importation and exportation of our products, the operation of our facilities and distribution of our products, and disclosure of
payments to healthcare professionals and entities. As we expand our operations footprint, countries to which we sell and invest in new business models,
compliance with applicable laws becomes more complex and the general trend is toward increasingly stringent oversight and enforcement.
Initiatives  sponsored  by  government  agencies,  legislative  bodies,  and  the  private  sector  to  limit  the  growth  of  healthcare  expenses  generally  are
ongoing in markets where we do business. It is not possible to predict at this time the long-term impact of such cost containment measures on our future
business.
Our customers are healthcare providers that may be reimbursed by state or federal funded programs such as Medicaid, a foreign national healthcare
program  or  private  pay  insurance,  each  of  which  may  offer  some  degree  of  oversight.  As  we  expand  our  customer  base  and  product  offering,  it  is
increasingly possible that there will be new opportunities to seek reimbursement from public and private payors for services that include our products, and
additional laws or regulatory enforcement requirements may apply now or in the future. Also, as a medical device manufacturer and seller, we are subject
to transparency reporting laws (also known as sunshine laws) that in certain countries require us to report transfers of value to healthcare professionals that
perform  services  or  receive  other  items  from  us  (e.g.,  meals,  travel,  branded  promotional  or  educational  items,  or  other  benefits  of  value).  Many
government agencies, both domestic and foreign, have increased their enforcement activities with respect to healthcare providers and companies in recent
years. Enforcement actions and associated efforts to respond or defend against such actions can be expensive, and any resulting findings carry the risk of
significant civil and criminal penalties.
In addition, we must comply with numerous data protection and storage requirements that span from individual state and national laws in the U.S.,
China and other countries, to multinational requirements in the EU, including laws that regulate or restrict cross border data transfers. In the U.S., we must
comply with final regulations implementing amendments to the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) and the associated
HIPAA Security Rule. We are also required to comply with the California Consumer Privacy Act and are preparing for a number of state-level laws and
bills in the U.S., including the California Privacy Rights Act of 2020. In the EU, we must comply with the General Data Protection Regulation, which
serves  as  a  harmonization  of  European  data-privacy  law  and  the  Swiss  Federal  Act  on  Data  Protection,  where  Align  has  its  EMEA  headquarters.  In
LATAM  markets,  we  must  comply  with  Brazil's  Lei  Geral  de  Proteção  de  Dados.  Meanwhile,  the  APAC  and  EMEA  regions  have  also  seen  rapid
development of privacy laws including Turkey, Morocco, Ghana, India, Russia, China, South Korea, Singapore, Hong Kong, Israel, and Australia.
Information regarding risks associated with data security and privacy may be found in Item 1A of this Annual Report on Form 10-K under the heading
“Risk Factors.”
Human Capital
We  believe  our  culture  and  commitment  to  employees  provide  unique  value  that  benefits  Align,  its  stockholders  and  the  communities  and  other
stakeholders we serve. Every employee, and every job, is important to our success and helps us achieve our purpose of transforming smiles and changing
lives. Fostering open dialogue, open-mindedness, compassion, fairness, recognition, and shared goals allows us to attract and retain the best talent, which
has ultimately led to the growth and success of our company.
As  of  December  31,  2021,  we  had  approximately  22,540  employees,  an  increase  of  approximately  25%  and  55%  over  December  31,  2020,  and
December 31, 2019, respectively. Included among our employees as of December 31, 2021, were approximately 14,200 in manufacturing and operations,
4,600 in sales and marketing (which includes customer care), 1,375 in research and development, and 2,365 in general and administrative functions. We are
a global organization with the majority of our employees in direct-labor roles in our manufacturing and clinical treatment planning facilities. Set forth in the
following paragraphs are some of the most important elements of our culture and commitment to our employees.
Governance. Our commitment to improving the lives of our employees and the communities in which we live and work, including conducting our
business ethically, responsibly and transparently through open and clear disclosures that allow us and others to hold us accountable, begins with our Board
of Directors (“Board”) and management team. They set the tone for our organization by establishing and clearly communicating our core values of Agility,
Customer and Accountability that inform our culture. Our Global Code of Conduct (“Code”) and quality policies are designed to enable us to operate with
integrity and deliver superior treatment outcomes and experiences to patients. We seek to create an environment that values the health, safety and well-
being  of  our  teams,  and  we  work  to  equip  them  with  the  knowledge  and  skills  to  serve  our  business  and  develop  in  their  careers.  We  believe  that  by
effectively managing our business with these values as the foundation, we will drive long-term value for our stockholders and all stakeholders.
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To demonstrate our commitment to our environmental, social and governance (“ESG”) efforts, our Board has delegated ESG oversight responsibility
to  our  Nominating  and  Governance  Committee.  In  2021,  our  Board  took  further  steps  to  support  ESG  by  amending  the  charter  of  our  Compensation
Committee to specifically empower the committee to oversee our diversity, equity and inclusion initiatives.
Diversity. Fostering diversity and encouraging inclusion in the workplace makes Align a more welcoming and enjoyable place to work. Our products
and services are used broadly across age groups, gender identities, races, ethnicities, and cultures, so we aim to build a workforce that optimally reflects
this  diversity.  We  believe  our  success  continues  to  be  driven  by  our  focus  on  integrating  employees  of  all  different  backgrounds,  orientations,  beliefs,
perspectives and capabilities into our workforce. Our approximately 22,540 employees bring a positive mix of ethnic and culturally diverse backgrounds to
the  more  than  40  different  countries  in  which  we  operate.  Our  management  team  is  comprised  of  diverse  individuals  from  varying  countries  and
nationalities and who are committed to promoting and encouraging the health and well-being of our employees at work, at home and in society in general.
Our work culture is designed to create financial, health, career and personal benefits for our employees and organization. We sponsor diverse and
cultural recognition events to increase awareness of inclusion and diversity, including its importance in creating an environment where every employee can
thrive.
We also sponsor employee resource groups based on shared characteristics or life experiences which are open to all employees, including those who
do not directly identify with other members but are passionate in supporting the group's members in creating an educated, supportive and inclusive culture.
Community.  We  provide  opportunities  for  and  actively  encourage  employees  to  support  local  charitable  organizations  through  volunteerism,  team
building, and donation and matching programs and are extremely proud of the generosity and dedication of our employees especially during our annual
Month  of  Smiles  initiative  in  October.  In  addition,  through  our  Align  Foundation,  we  support  organizations  whose  visions  closely  align  with  our  own,
including Operation Smile and America’s ToothFairy. We also provide product donations to the dental community to help patients in need of a healthy,
beautiful smile. For more information on our charitable and community efforts, please refer to the Corporate Social Responsibility portion of our corporate
website located at https://www.aligntech.com/about/corporate_social_responsibility.
Talent Recruitment and Engagement. We employ a variety of career development, employee benefits, compensation and other policies and programs
designed to attract, develop, and retain employees. We focus on building a talent pipeline that nurtures those early in their careers, encourages continuous
learning and growth, and incentivizes our employees to stay and contribute to our success over the long term. Our programs include early recruitment at
high schools and universities, initiatives such as internships, co-ops, apprenticeships, and training programs, quarterly performance management check-ins
focused on individual goals and commitment to values and conducting regular employee surveys to build trust and strengthen relationships. Our efforts
have proven successful, resulting in numerous awards for our positive work environment and culture. In 2021 alone, we were recognized by:
Forbes as one of their World’s Best Employers in 2021
•
• Great  Places  to  Work  and  Best  Places  to  Work  based  on  our  employee-validated  great  workplaces  in  the  following  countries  -  Brazil,  Canada,
•
China, Costa Rica, Germany, India, Poland, Singapore, U.S., and Vietnam
Computerworld as Best Place to Work in IT, based in its survey of organizations across the U.S. to identify those that provide the best benefits and
amenities for IT professionals
Training and Professional Development. Training is an integral part of developing and retaining our employees and creating a culture of leadership
within the Company. In 2021, 54% of our employees engaged in some form of professional development activities. The U.S. Department of Labor uses the
benchmark of 23% as a best practice standard for companies.
Training at Align begins with our Code and our strong commitment to ethical business practices in all aspects of our operations. Every employee and
contractor  is  required  to  review  the  Code  and  confirm  they  understand  it.  We  routinely  reference  the  Code  in  presentations  and  as  part  of  everyday
operations.
As a further part of our standard onboarding program, we train employees on important environmental health and safety topics to protect them and
our environment as we operate our business. As a general practice, employees are trained to perform their jobs in accordance with any and all applicable
statutory and regulatory requirements and that training is routinely re-administered, updated and refreshed.
Employees are encouraged to participate in a variety of Company-provided learning resources through our corporate platform Align University. The
platform offers a broad range of development tools with more than 1,000 courses available in multiple languages to serve our many employees globally,
including professional development events, external training
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programs  based  on  individual  needs,  business-led  enterprise  leader  learning  events,  diversity  and  inclusion,  online  business  skills  courses  and  onsite
classroom  events.  This  is  in  addition  to  opportunities  offered  for  job  development  such  as  our  Early  Leader  program  as  well  as  the  Align  Leadership
Journey, for which our program on creativity and curiosity was recognized with a Brandon Hall Innovation Award, and other management skills training
and trainings that create opportunities for advancement.
Compensation  and  Benefits.  Our  commitment  to  our  employees  starts  with  benefit  and  compensation  programs  that  reflect  the  value  and  the
contributions  our  employees  make.  In  addition  to  competitive  base  pay,  we  offer  an  assortment  of  benefits  that  vary  by  country,  including  health  and
welfare benefit plans, retirement planning services and benefits, holiday and leave policies, equity participation programs such as our Incentive Plan and
Employee  Stock  Purchase  Plan,  and  charitable  and  community  service  opportunities.  Besides  these,  we  also  offer  discounts  to  our  employees  and  their
dependents when they undergo Invisalign treatment.
We  are  furthermore  committed  to  pay  equity  practices.  We  regularly  review  our  pay  equity  practices,  none  of  which  have  shown  any  systemic
differences in pay or pay practices.
Recognizing  that  financial  security  is  as  important  to  the  emotional  health  and  well-being  of  our  employees  as  physical  precautions  against  the
COVID-19 virus and its many variants, we committed at the outset of the pandemic to protect our employees and their families financially by declaring we
would not furlough, lay off or cut employee pay. We have honored this commitment throughout the pandemic.
Health  and  Safety.  Our  employees  are  essential  to  us  as  a  business  and  their  health  and  well-being  is  critical  to  our  success  and  their  continuing
achievements. Our objective is to prevent injuries and occupational diseases by focusing first and foremost on creating and maintaining environments that
are safe. We therefore offer a wide variety of robust programs and initiatives designed to promote the overall health and welfare of all our employees and
their families. In addition to the compensation and benefits listed above, we offer family support services, healthcare initiatives and career services support,
among many others. In response to the COVID-19 pandemic and the impacts of remote working, we have encouraged employees to take time away from
work to be with their families and implemented initiatives to promote better work-life balance. In addition, we have several health and safety programs in
place to help protect our employees. For instance, we have training programs and courses that employees exposed to particular risks are required to take
and update periodically. Examples include hazardous material training, emergency response and evacuation training, ergonomics training, biohazard and
personal protective equipment training, and, more recently, COVID-19 related safety training.
We have an Environmental Health, Safety and Sustainability Director who is responsible for ensuring health and safety programs are maintained and
effective at each of our locations. Major worksites, such as our aligner fabrication sites, and large offices have dedicated Environmental Health and Safety
(“EHS”) departments that ensure health and safety programs are maintained while contributing Best Management Practices (“BMP”) and general input to
corporate-wide programs. Each EHS department is responsible for ensuring all employees at their location are properly trained on various EHS topics and
at the appropriate frequencies. A training suite is determined for each employee depending on their responsibilities and function modeled off of ISO 45001.
Available Information
Our  corporate  website  is  www.aligntech.com,  and  our  investor  relations  website  is  http://investor.aligntech.com.  The  information  on  or  accessible
through our websites is not part of this Annual Report on Form 10-K. Our Annual Report on Form 10-K, Quarterly Reports on Form 10-Q, Current Reports
on Form 8-K, our proxy statement on Schedule 14A for our annual stockholders’ meeting and amendments to such reports are available, free of charge, on
our  investor  relations  website  as  soon  as  reasonably  practicable  after  we  electronically  file  or  furnish  such  material  with  the  SEC.  Further,  the  SEC
maintains an internet site that contains reports, proxy and information statements and other information regarding our filings at http://www.sec.gov.
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Information about our Executive Officers
The following table sets forth certain information regarding our executive officers as of February 25, 2022:
Name
Joseph M. Hogan
John F. Morici
Julie Coletti
Stuart Hockridge
Emory M. Wright
Age
64
55
54
50
52
Position
President and Chief Executive Officer
Chief Financial Officer and Executive Vice President, Global Finance
Executive Vice President, Chief Legal and Regulatory Officer
Executive Vice President, Global Human Resources
Executive Vice President, Global Operations
Joseph  M.  Hogan  has  served  as  our  President  and  Chief  Executive  Officer  and  as  a  member  of  our  Board  of  Directors  since  June  2015.  Prior  to
joining us, Mr. Hogan was Chief Executive Officer of ABB Ltd., a global power and automation technologies company based in Zurich, Switzerland from
2008 to 2013. Prior to working at ABB, Mr. Hogan worked at General Electric Company (GE) in a variety of executive and management roles from 1985
to 2008, including eight years as Chief Executive Officer of GE Healthcare from 2000 to 2008.
John F. Morici served as our Chief Financial Officer beginning in November 2016. His title was changed to Chief Financial Officer and Senior Vice
President, Global Finance in February 2018 and was changed again in February 2022 to Chief Financial Officer and Executive Vice President. Prior to
joining  us,  Mr.  Morici  was  at  NBC  Universal  from  2007  to  2016  where  he  held  several  senior  management  positions  in  their  Universal  Pictures  Home
Entertainment U.S. and Canadian business, including Chief Financial Officer, Chief Operating Officer, and most recently, Executive Vice President and
Managing Director from 2014 to 2016. Prior to NBC Universal, Mr. Morici was in various senior financial management positions at GE Healthcare from
1999 to 2007, including Chief Financial Officer for its Diagnostic Imaging and Global Products units from 2002 to 2003.
Julie Coletti served as our Senior Vice President, Chief Legal and Regulatory Officer from May 2019 until February 2022 when her title was changed
to Executive Vice President, Chief Legal and Regulatory Officer. Ms. Coletti joined Align in May 2018, serving as Vice President and Associate General
Counsel,  Strategic  Commercial  Affairs  until  her  promotion  in  2019.  Prior  to  Align,  Ms.  Coletti  was  Vice  President,  Global  General  Counsel  and  Chief
Compliance Officer for Danaher Corporation, a healthcare, environmental and industrial equipment manufacturer, in its dental platform business. Before
Danaher,  Ms.  Coletti  served  in  various  senior  legal  management  positions,  including  as  Vice  President,  Chief  Legal  Officer  and  Corporate  Secretary  at
Bayer  HealthCare's  MEDRAD/Radiology  and  Interventional  Division,  a  leading  manufacturer  of  pharmaceuticals  and  medical  devices  for  imaging  and
interventional cardiology.
Stuart Hockridge served as our Vice President, Global Human Resources beginning in May 2016. His title was changed to Senior Vice President,
Global  Human  Resources  in  February  2018  and  was  changed  again  in  February  2022  to  Executive  Vice  President,  Global  Human  Resources.  Prior  to
joining  us,  Mr.  Hockridge  was  Senior  Vice  President  of  Talent  at  Visa  Inc.  from  2013  to  2016.  Prior  to  Visa,  Mr.  Hockridge  held  a  number  of  human
resource management positions at GE Healthcare from 2002 to 2012 leading HR processes both globally and for various divisions.
Emory  M.  Wright  served  as  our  Vice  President,  Operations  beginning  in  December  2007.  His  title  changed  to  Senior  Vice  President,  Global
Operations in February 2018 and was changed again in February 2022 to Executive Vice President, Global Operations. He has been with us since March
2000  predominantly  in  manufacturing  and  operations  roles  including  Vice  President,  Manufacturing  and  was  General  Manager  of  New  Product
Development. Prior to joining Align, from 1999 to 2000, Mr. Wright was Senior Manufacturing Manager at Metrika, Inc. a medical device manufacturer.
Mr. Wright also previously served as Manager of Manufacturing and Process Development for Metra Biosystems Inc.
Item 1A. Risk Factors.
The following discussion is divided into two sections. The first, entitled “Risks Relating to our Business Operations and Strategy,” discusses some of
the risks that may affect our business, results of operations and financial condition. The second, captioned “General Risk Factors,” discusses some of the
risks  that  apply  generally  to  companies  and  to  owning  our  common  stock,  in  particular.  You  should  carefully  review  both  sections,  as  well  as  our
consolidated  financial  statements  and  notes  thereto  and  other  information  appearing  in  this  Annual  Report  on  Form  10-K,  for  important  information
regarding these and other risks that may affect us. The order we have chosen to list the risks below or the sections in which we have identified them should
not  be  interpreted  to  mean  we  deem  any  risks  to  be  more  or  less  important  or  likely  to  occur  or,  if  any  do  occur,  that  their  impact  may  be  any  less
significant than others. These risk factors should be considered in connection with evaluating the
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forward-looking statements contained in this report because they could cause our actual results and conditions to differ materially from those statements.
Before you invest in Align, you should know that investing involves risks, including those described below. The risks below are not the only ones we face. If
any of the risks actually occur, our business, financial condition and results of operations could be negatively affected, the trading price of our common
stock could decline, and you may lose all or part of your investment.
Summary of Risk Factors
The following is a summary of the risks that are more fully described below in this “Risk Factors” section:
Risks Relating to our Business Operations and Strategy
• Our results of operations have been materially adversely affected by global and regional efforts to mitigate the spread of COVID-19 and we expect
this will continue in as yet unknown ways and to varying degrees as the virus evolves and circumstances dictate.
• Our net revenues are dependent primarily on our Invisalign system and iTero scanners and any decline in sales or average selling price of these
products, for any reason, may adversely affect net revenues, gross margin and net income.
• Competition in the markets for our products is increasing and we expect aggressive competition from existing competitors, other companies that
may  introduce  new  technologies  in  the  future  and  customers  who  alone  or  with  others  create  orthodontic  appliances  and  solutions  or  other
products or services that compete with us.
• An  increasingly  larger  portion  of  our  total  revenues  are  derived  from  international  sales  and  we  are  dependent  on  our  international  operations,
which exposes us to foreign operational, political, military and other risks that may harm our business.
• Demand for our products may not increase as rapidly as we anticipate or may decrease due to a variety of factors, including changing consumer
demand, inflation, weakness in general economic conditions, recessions and resistance to non-traditional treatment methods.
• Our success depends on our ability to develop, successfully introduce, achieve market acceptance of, and manage new products and services.
• As  we  continue  to  grow,  we  are  subject  to  growth  related  risks,  including  risks  related  to  excess  or  constrained  capacity  and  operational
inefficiencies at our manufacturing and treat facilities.
•
• Our  products  and  information  technology  systems  are  critical  to  our  business.  Issues  with  product  development  or  enhancements,  IT  system
integration,  implementation,  updates  and  upgrades  along  with  security  and  data  protection  risks  have  previously  and  could  again  in  the  future
disrupt our operations, which could have a material adverse impact on our business and operating results.
If we are unable or fail to protect our customer or patient information or if we are unable to comply with applicable privacy, security and data
protection laws, our operations may be severely adversely impacted, patient care could suffer, we could be liable for related damages, and our
business, operations and reputation could be harmed.
If we fail to sustain or increase revenue growth while controlling expenses, our profitability may decline.
•
• Our operating results have and will continue to fluctuate in the future, which makes predicting the timing and amount of our revenues, costs and
expenditures difficult.
• A disruption in the operations of a primary freight carrier, higher shipping costs or shipping delays could disrupt our supply chain and cause a
•
decline in our net revenues or a reduction in our earnings.
If  we  fail  to  accurately  predict  our  volume  growth,  hire  too  many  or  too  few  technicians,  or  manufacture  too  many  or  too  few  products,  the
delivery  time  for  our  products  could  be  delayed  or  our  costs  may  exceed  our  revenues,  each  of  which  could  adversely  affect  our  results  of
operations.
• We are dependent on our marketing activities to deepen our market penetration and raise awareness of our brand and products, which may not
prove successful or may become less effective or more costly to maintain in the long term.
• Our success depends in part on our proprietary technology, and if we fail to successfully obtain or enforce our intellectual property (“IP”) rights,
our competitive position may be harmed. Litigating claims of this type is costly and could distract our management and cause a decline in our
results of operations and stock price.
If we or any vendors on whose products or services we rely for our products and services infringe the patents or IP rights of other parties or are
subject to a patent infringement claim, our ability to grow our business may be severely limited.
•
• Obtaining  approvals  and  complying  with  governmental  regulations,  particularly  those  related  to  personal  healthcare  information,  financial
information, quality systems and data privacy, is expensive and time-consuming, and any failure to obtain or maintain approvals or comply with
regulations regarding our products or services or the products and services of our suppliers or customers could materially harm our sales, result in
substantial penalties and cause harm to our reputation.
• We are highly dependent on third-party suppliers, some of whom are sole source suppliers, for certain key machines, components and materials,
and  our  business  and  operating  results  could  be  harmed  if  supply  is  restricted  or  ends  or  the  price  of  raw  materials  used  in  our  manufacturing
process increases.
17
• We rely on highly skilled personnel and, if we fail to attract, motivate, train or retain highly skilled personnel, it may be more difficult to grow
effectively and pursue our strategic priorities.
• We use distributors for a portion of the importation, marketing and sales efforts related to our products and services, which exposes us to risks that
may be harmful to our sales and operations, including that these distributors do not comply with applicable laws or our internal procedures.
• Our business exposes us to potential liability for the quality and safety of our products and services, how we advertise and market those products
and services and how and to whom we sell them, and we may incur substantial expenses or be found liable for substantial damages or penalties if
we are subject to claims or litigation.
• Compliance with current or future environmental, social, and governance (“ESG”) laws may materially increase our costs, expose us to potential
liability and otherwise materially impact our business.
General Risk Factors
• We  rely  on  our  personnel  and,  if  we  fail  to  attract,  motivate  or  retain  personnel,  or  if  our  growth  harms  our  corporate  culture,  it  may  be  more
difficult to grow effectively and pursue our strategic priorities.
Business disruptions could seriously harm our financial condition.
Changes in, or interpretations of, accounting rules and regulations, could result in unfavorable accounting charges.
•
•
• We are required to annually assess our internal control over financial reporting and any adverse results from such assessment may result in a loss
of investor confidence in our financial reports and have an adverse effect on our stock price.
• We are exposed to fluctuations in currency exchange rates and inflation, each of which could negatively affect our financial condition and results
•
of operations.
If we fail to manage our exposure to global financial and securities market risks successfully, our operating results and financial statements could
be materially impacted.
If our goodwill or long-lived assets become impaired, we may be required to record a significant charge to earnings.
•
• Our effective tax rate may vary significantly from period to period.
• New  tax  laws  and  practice,  changes  to  existing  tax  laws  and  practice,  or  disputes  regarding  the  positions  we  take  regarding  tax  laws,  could
negatively affect our provision for income taxes as well as our ongoing operations.
• We  have  in  the  past  and  may  again  in  the  future  invest  in  or  acquire  other  businesses,  products  or  technologies  which  may  require  significant
management attention, disrupt our business, dilute stockholder value and adversely affect our results of operations.
• Historically, the market price for our common stock has been volatile.
• We cannot guarantee that we will continue to repurchase our common stock in the future, and any repurchases that we may make may not achieve
•
•
our desired objectives.
Future sales of significant amounts of our common stock may depress our stock price.
Increased scrutiny of our ESG policies and practices have and will likely continue to result in additional costs and risks, and may adversely impact
our reputation, employee retention, and willingness of customers and suppliers to do business with us.
Risks Relating to our Business Operations and Strategy
Our results of operations have been materially adversely affected by global and regional efforts to mitigate the spread of COVID-19 and we expect
this will continue in as yet unknown ways and to varying degrees as the virus evolves and circumstances dictate.
The broad and extensive impact of the COVID-19 pandemic on virtually all aspects of our business and society has exacerbated many pre-existing
risks to our business by making them more likely to occur or more impactful when they do occur. Accordingly, you should consider the risks described in
this risk factor in addition to, and not in lieu of, the risks described elsewhere throughout these risk factors.
COVID-19  has  created  significant,  widespread  and  unprecedented  volatility,  uncertainty,  and  economic  instability,  disrupting  broad  aspects  of  the
global economy, our operations and the businesses of our customers and suppliers. Many of these effects continue to varying degrees and further mutated
variants  and  outbreaks  globally  or  regionally  continue  to  harm  recovering  consumer  confidence  and  have  led  to  renewed  implementation  of  harsh
preventative measures by local and regional governments and businesses. Therefore, comparing our financial results for the reporting periods of 2021 to the
same reporting periods of 2020 or 2019 may not be a useful means by which to evaluate the health of our business and our results of operations.
As  a  result  of  the  pandemic,  customer  demand  and  doctor  availability  has  been  inconsistent  and  difficult  to  predict.  Although  the  practices  of  the
doctors, dental service organizations and labs that are our principal customers have largely reopened, many continue to operate at less than pre-pandemic
capacities.  In  addition,  new  variants  of  the  virus  have  caused  unpredictable  fluctuations  in  the  number  of  patients  seeking  treatment  and  the  number  of
doctors providing the services and
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treatments. While the pandemic increased demand for digital solutions such as the products and solutions we offer for the dental field, it is unclear whether
increased  demand  for  our  products  will  continue.  For  instance,  if  the  use  of  video  conferencing  declines  when  employees  return  to  office  work
environments or the availability of travel, dining, entertainment and other consumer spending categories rebound, demand for our products or the growth
rates  for  our  products  may  decline.  These  fluctuations  have  adversely  impacted  our  results  of  operations  from  time  to  time  in  the  recent  past  and  are
expected to continue to impact our results, particularly in the near term.
In response to the pandemic, in 2020 we implemented measures aimed at limiting its spread for the health and safety of our employees, customers,
patients  and  the  communities  in  which  we  live  and  work  as  well  as  in  accordance  with  orders  and  decrees  of  governmental  agencies.  These  measures
included diagnostic screenings at our facilities, increased social distancing mandates, closures of physical offices, manufacturing and treatment planning
facilities, including our U.S. corporate headquarters and regional facilities worldwide, implementing remote working where feasible, and prohibiting non-
essential  travel.  Many  of  these  actions  remain  in  effect  to  varying  degrees  and  we  may  implement  new  or  revise  existing  measures  as  circumstances
require. The actions and reactions to voluntary and involuntary protective measures have been highly disruptive to our business and may continue to be
disruptive.
The rules and regulations for reopening and operating our offices will likely increase in complexity, making compliance more difficult. Furthermore,
if employees perceive the protocols and requirements we implement to create a safe and effective work environment to be inadequate, overly burdensome
or no longer necessary, or alternatively, if we require employees to return to the office when they prefer the safety or convenience of working from home,
employees may choose to leave, productivity may decline or we may experience employee unrest, slowdowns, stoppages or other demands. Additionally,
we may fail to timely meet customer demand or fulfill orders, the costs to maintain or implement protective measures or deliver our products may increase,
and we may be subject to increased litigation, including product liability and occupational safety and condition claims. For further discussion or the risks
related  to  employee  satisfaction,  retention  and  engagement  see  the  risk  factor  “We  rely  on  our  personnel  and,  if  we  fail  to  attract,  motivate  or  retain
personnel, or if our growth harms our corporate culture, it may be more difficult to grow effectively and pursue our strategic priorities.”
As the economic and societal impact of the pandemic continues, we are continually evaluating macroeconomic as well as industry-specific factors,
including the extent our business and financial results and the business and financial results of our customers’ and suppliers’ have been and in the future
may be impacted. The financial health and stability of businesses and consumers overall depends on numerous evolving factors, many of which we cannot
control nor accurately predict. Examples include:
•
•
•
•
•
the duration, scope, and severity of governmental, business and societal actions in response to the pandemic;
the impact on worldwide economic activity, employment rates and actions taken by central banks and governments;
customer  and  consumer  purchasing  behavior  changes  as  pandemic-related  restrictions  are  curtailed,  lifted  or  reinstated,  and  travel  and
discretionary spending patterns shift;
the response of employees, customers and suppliers to the reimplementation or easing of social distancing mandates and returning to in-office or
facility working, including anxieties regarding the continuing risks of the spread of the virus or any of its variants, vaccination requirements, and
other mandates that may impact employee productivity and engagement, retention or require additional costly protective measures;
the  liquidity  of  funds  and  financial  stability  of  consumers,  customers,  and  patients,  including  their  willingness  to  purchase  our  products  and
services, delays paying for products or services, requests for extended payment terms, or payment defaults;
• disruptions and shortages impacting the cost, availability and timing of the procurement, delivery, manufacturing and overall supply chain for raw
materials, components, parts and products, including semiconductor chips;
•
• delays and cancellations as a result of port congestion and intermittent supplier shutdowns;
•
travel and gathering restrictions, including those that adversely impair or prohibit our sales personnel from interacting with customers or that limit
patients from visiting their doctors or capacity limits on the number of patients doctors can see in their offices;
actions by competitors such as price reductions, aggressive product promotions, changes in or the launch or termination of products or product
lines, and mergers, consolidations and liquidations;
the confidence of our customers and patients that our products and solutions are sanitary and safe to use;
•
• data  privacy  and  cybersecurity  risks  from  new  or  expanded  use  of  remote  working  and/or  teledentistry  by  our  suppliers,  customers,  and  us,
including new or expanded use of online service platforms, products and solutions such as video conferencing applications, doctor, consumer and
patient apps, inadequately secured computing networks, servers, software or software applications, overheard telephone conversations, viewable
computer screens, stolen passwords or access information, increased phishing and other cyber threats;
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•
the impact of remote working arrangements on our financial reporting systems and internal control over financial reporting, including our ability
to  ensure  information  required  to  be  disclosed  is  timely  and  accurately  recorded,  processed,  summarized,  reported,  and  communicated  to
management, including our Chief Executive Officer and Chief Financial Officer, as appropriate, to allow for timely decisions regarding required
disclosure; and
• diversion of management’s attention as they focus on the short- and long-term ramifications of the pandemic.
The  effects  of  the  pandemic  continue  to  linger  and  evolve  and  we  cannot  predict  future  direct  and  ancillary  impacts  on  our  business  or  results  of
operations, although they may have a material adverse effect on our business, financial condition, results of operations, cash flows and stock price as well
as the businesses of our customers, suppliers and economic activity generally.
Our net revenues are dependent primarily on our Invisalign system and iTero scanners and any decline in sales or average selling price of these
products, for any reason, may adversely affect net revenues, gross margin and net income.
Our net revenues remain largely dependent on sales of our Invisalign system of clear aligners and iTero intraoral scanners. Of the two, we expect net
revenues  from  the  sale  of  the  Invisalign  system,  primarily  our  comprehensive  products,  will  continue  to  account  for  the  majority  of  our  net  revenues,
making the continued and widespread acceptance of the Invisalign system by orthodontists, GPs and consumers critical to our future success. Our iTero
scanners  have  become  a  material  percentage  of  our  overall  revenues.  Although  exocad  and  its  CAD/CAM  software  solutions  are  important  to  the
continuing evolution of the Align digital platform, the contributions to our total net revenues from the exocad solutions remain immaterial. Our operating
results could be harmed if:
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orthodontists and GPs experience a reduction in consumer demand for orthodontic services;
consumers prove unwilling to adopt Invisalign system treatment as rapidly or in the volumes we anticipate and at the prices offered;
orthodontists or GPs choose to continue using wires and brackets or competitive products rather than the Invisalign system or the rates at which
they utilize the Invisalign system fail to increase or increase as rapidly as anticipated;
sales of our iTero scanners decline or fail to grow sufficiently or as expected;
the growth of CAD/CAM solutions does not produce the results expected; or
if the average selling price of our products declines.
The average selling prices of our products, particularly our Invisalign system, are influenced by numerous factors, including the type and timing of
products sold (particularly the timing of orders for additional clear aligners for certain Invisalign products) and foreign exchange rates. In addition, we sell
a  number  of  products  at  different  list  prices  which  may  differ  based  on  country.  Our  average  selling  prices  have  been  impacted  in  the  past  and  may  be
adversely affected again in the future if:
• we introduce new or change existing promotions, general or volume-based discount programs, product or services bundles, or consumer rebate
programs;
participation in any promotions or programs unexpectedly increases or decreases or drives demand in unexpected and material ways;
our geographic, channel, or product mix shifts to lower priced products or to products that have a higher percentage of deferred revenue;
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• we decrease prices on one or more products or services in response to increasing competitive pricing pressures;
• we introduce new or change existing products or services, or modify how we market or sell any of our new or existing products or services; or
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our critical accounting estimates materially differ from actual behavior or results.
If any of the foregoing were to occur, our net revenues, gross profit, gross margin and net income may decline.
Competition in the markets for our products is increasing and we expect aggressive competition from existing competitors, other companies that
may introduce new technologies in the future and customers who alone or with others create orthodontic appliances and solutions or other products or
services that compete with us.
The dental industry is in a period of immense and rapid digital transformation involving products, technologies, distribution channels and business
models.  While  solutions  such  as  our  Invisalign  system,  iTero  scanners  and  CAD/CAM  software  facilitate  this  transition,  whether  our  technologies  will
achieve market acceptance and, if adopted, whether and when they may become obsolete as new offerings become available remains unclear.
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Currently, the Invisalign system competes directly against traditional metal wires and brackets and increasingly against clear aligners manufactured
and distributed by new market entrants and manufacturers of traditional wires and brackets, both within and outside the U.S., and from traditional medical
device companies, laboratories, startups and, in some cases, doctors and DSOs themselves. Due in part to market opportunities and the expiration of certain
of our key patents beginning in 2017, competition in the clear aligner market is increasing. The number and types of competitors are diverse and growing
rapidly. They vary by segment, geography, and size, and include new and well-established regional competitors, as well as larger companies or divisions of
larger companies with substantial sales, marketing, research financial capabilities, and existing dental market channels. Our competitors also include direct-
to-consumer  (“DTC”)  companies  that  provide  clear  aligners  using  a  remote  teledentistry  model  requiring  little  or  no  in-office  care  from  trained  and
licensed  doctors,  and  doctors  and  DSOs  who  can  manufacture  custom  aligners  in  their  offices  using  modern  3D  printing  technology.  Large  consumer
product companies may also enter the orthodontic supply market.
The manipulation and movement of teeth and bone is a complex and delicate process with potentially painful and debilitating results if improperly
performed  or  monitored.  Accordingly,  we  are  committed  to  delivering  our  Invisalign  system  solutions  primarily  through  trained  and  skilled  doctors.
Invisalign system treatment requires a doctor's prescription and an in person physical examination of the patient’s dentition before beginning treatment;
however, with the advent of DTC providers, there has been a shift away from traditional dental practices that may impact our primary selling channels.
Doctors  and  DSOs  are  sampling  alternative  products  and  taking  advantage  of  competitive  promotions  and  sale  opportunities.  In  addition,  we  face
competition from companies that introduce new technologies and we may be unable to compete with these competitors or they may render our technology
obsolete or economically unattractive. If we are unable to compete effectively with existing products or respond effectively to any new technologies, our
business could be harmed.
To  stimulate  product  and  services  demand,  we  have  a  history  of  offering  volume  discounts,  price  reductions  and  other  promotions  to  targeted
customers and consumers. Whether or not successful, these promotional campaigns have had and may in the future again have unexpected and unintended
consequences, including reduced gross margins, profitability and average selling prices, net revenues, volume growth, and net income.
We cannot assure that we will be able to compete successfully against our current or future competitors or that competitive pressures will not have a
material adverse effect on our business, results of operations and financial condition.
An increasingly larger portion of our total revenues are derived from international sales and we are dependent on our international operations,
which exposes us to foreign operational, political, military and other risks that may harm our business.
We earn an increasingly larger portion of our total revenues from international sales generated through our foreign direct and indirect operations and
we expect to increase our sales and presence outside the U.S., particularly in markets we believe have high-growth potential. Moreover, we perform many
of our key production steps in locations outside of the U.S. For instance, our digital treatment planning and aligner fabrication are performed in multiple
international  locations,  including  large-scale  operations  in  Mexico,  Costa  Rica  and  China  and  we  continue  to  establish  additional  sites  closer  to  our
international  customers,  such  as  our  manufacturing  facility  in  Poland  currently  under  construction.  Also,  we  maintain  significant  regional  sales  and
marketing operations in Switzerland, Singapore and China along with research and development operations globally, including in the U.S., Russia, Israel
and Germany. Our reliance on international operations exposes us to risks and uncertainties that may affect our business or results of operations, including:
• difficulties managing international operations, including any travel restrictions on us or our customers;
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fluctuations in currency exchange rates;
import and export risks, including shipping delays, cost increases, penalties, controls, license requirements and restrictions;
controlling production volume and quality of the manufacturing process;
the engagement in activities by our employees, contractors, partners and agents prohibited by our policies and procedures as well as international
and local trade, labor and other laws such as those prohibiting bribery and corrupt payments to government officials, including the U.S. Foreign
Corrupt Practices Act, the U.K. Bribery Act of 2010 and export control laws;
• delays, disruptions and increasing costs to us and our suppliers for raw materials or components, manufacturing, and transportation, including as a
result  of  customs  clearance,  port  congestion,  workforce  unrest  or  labor  shortages,  slowdowns  or  stoppages,  unionization  efforts,  or  disasters,
whether natural forces or human caused;
increased expense of developing, testing, manufacturing and marketing localized versions of our products;
threats, tensions, actions and responses to any social, economic, business, geopolitical, military, terrorism, or acts of war, including the possibility,
threat of, imposition of, or changes in sanctions, trade restrictions and tariffs, as well as
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retaliatory military actions, sanctions, trade restrictions and tariffs particularly involving key customers, development or manufacturing markets
such as China, Mexico, Russia, the Middle East, Eastern Europe or other countries;
• Some of our employees in Israel are obligated to perform annual reserve duty in the Israeli military and may be called for additional active duty
under emergency circumstances which may materially impair all or a portion of our business critical to our iTero operations. Additionally, we have
significant  research  and  development  activities  in  Russia  that  may  be  impaired  should  any  threatened  or  actual  military  actions  occur  in  the
Ukraine or other countries. If any of these events or conditions occur, the impact to us, our employees and customers is uncertain, particularly if
emergency  circumstances,  armed  conflicts  or  an  escalation  in  political  instability  or  violence  disrupts  our  product  development,  data  or
information  exchange,  payroll  or  banking  operations,  product  or  materials  shipping  by  us  or  our  suppliers  and  other  unanticipated  business
disruptions, interruptions  and  limitations  in  telecommunication  services  or  critical  systems  or  applications  reliant  on  a  stable  and  uninterrupted
communications  infrastructure.  Moreover,  we  have  developed  a  multi-dimensional  business  continuity  plan  designed  to  mitigate  the  impact  of
potential actions and reactions to a military incursion in Ukraine and other areas, but it is unclear if it will successfully and adequately mitigate
against any actions taken or sanctions imposed;
• burdens of complying with a wide variety of regional and local laws, including anti-trust, fair competition and environmental laws;
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the impact of initiatives to encourage the purchase or support of domestic vendors, which can influence customers to purchase products from, or
collaborate to promote interoperability of products with, companies whose headquarters or primary operations are not domestic;
reduced IP rights protections as compared to the protections afforded under the laws of the U.S.;
longer customer payment cycles and greater difficulty in accounts receivable collection; and
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• potential adverse tax consequences.
The potential impacts of the United Kingdom’s (“UK”) withdrawal from the EU are still unfolding and have impacted varying parts of its economy at
different times since the withdrawal. As the UK negotiates new trade deals and implements new laws and regulations following its withdrawal, the UK’s
actions  could,  among  other  potential  outcomes,  adversely  affect  the  tax,  tax  treaty,  currency,  operational,  legal  and  regulatory  regimes  to  which  our
businesses  are  subject,  including  those  involving  data  privacy  and  the  regulation  of  medical  devices.  The  withdrawal  could  also,  among  other  potential
outcomes,  disrupt  the  free  and  timely  movement  of  goods,  services,  people,  data  and  information  and  significantly  disrupt  trade.  Further,  uncertainty
around these and related issues could lead to adverse effects on the economies and political stability of the UK, EU and the other economies in which we
operate.
Should any of these factors, either individually or in combination, occur they could materially impact our international operations and adversely affect
our business as a whole.
Demand for our products may not increase as rapidly as we anticipate or may decrease due to a variety of factors, including changing consumer
demand, inflation, weakness in general economic conditions, recessions and resistance to non-traditional treatment methods.
Consumer spending habits are affected by, among other things, pandemics, inflation, weakness in general economic conditions, recessions, levels of
employment,  salaries  and  wage  rates,  debt  obligations,  discretionary  income,  consumer  confidence  and  consumer  perception  of  current  and  future
economic  conditions.  Declines  in,  or  uncertain  economic  outlooks  for,  the  U.S.  or  certain  international  economies  could  adversely  affect  consumer
spending habits which may, among other things, result in a decrease in the number of overall orthodontic and dental case starts, reduce patient traffic in
dentists’ offices, reduce or shift spending away from elective, non-urgent, or higher value procedures or reduce demand for dental services generally, any of
which could materially adversely affect our revenues and operating results. Conversely, to the extent social distancing, travel, work and other restrictions
have  limited  options  for  consumer  spending,  demand  for  our  products  may  decline  once  any  or  all  of  these  restrictions  ease.  Inflation,  weakness  in  the
global or regional economies and recessions can decrease demand for dental technologies, causing dentists to postpone investments in capital equipment,
such  as  intraoral  scanners  and  CAD/CAM  software.  In  addition,  Invisalign  treatment  represents  a  significant  change  from  traditional  metal  wires  and
brackets orthodontic treatment, and customers and consumers may not find it cost-effective or preferable to traditional treatment. For instance, a number of
dental professionals continue to believe the Invisalign treatment is appropriate for only a limited percentage of patients. Increased market acceptance of our
products depends in part upon the recommendations of dental professionals, as well as other factors including effectiveness, safety, ease of use, reliability,
aesthetics, and price compared to competing products and treatment methods.
Our success depends on our ability to develop, successfully introduce, achieve market acceptance of, and manage new products and services.
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Our  success  depends  on  our  ability  to  profitably  and  quickly  develop,  manufacture,  market  and  obtain  regulatory  approval  or  clearance  of  new
products  and  services  along  with  improvements  to  existing  products  and  services.  There  is  no  assurance  we  can  successfully  develop,  sell  and  achieve
market  acceptance  of  our  new  products  and  services.  The  extent  of,  and  rate  at  which,  new  products  or  offerings  may  achieve  market  acceptance  and
penetration is a function of many variables, including our ability to:
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successfully predict and timely innovate and develop new technologies and applications with the features and functionality customers desire or
expect;
successfully  and  timely  obtain  approval  or  clearance  of  new  products  or  services  from  government  agencies  such  as  the  FDA  and  analogous
agencies in other countries;
cost effectively manufacture, bring to market, market, and sell new products and services offerings;
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• differentiate our products and product offerings from our competitors as well as other products in our own portfolio and successfully articulate the
allocate our research and development funding to products with higher growth prospects;
ensure compatibility of our technology, services and systems with those of our customers;
anticipate and rapidly innovate in response to new competitive products, product offerings and technologies;
benefits to our customers;
• qualify for third-party reimbursement for procedures involving our products; and
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encourage customers to adopt new technologies and provide the needed technical, sales and marketing support to make new product and services
launches successful.
If  we  fail  to  accurately  predict  customer  needs  and  preferences  or  fail  to  produce  viable  technologies,  we  may  invest  heavily  in  research  and
development of products that do not lead to significant revenues. Even if we successfully innovate and develop new products and product enhancements,
we  may  incur  substantial  costs  doing  so  and  our  profitability  may  suffer.  It  may  be  difficult  to  gain  market  share  and  acceptance  for  new  or  enhance
products. Introduction and acceptance of new products may take significant time and effort if the products or services require doctor education and training
to understand the benefits of the new products or they measure the success of a product only after using it to treat patients. For instance, it can take up to 24
months  or  longer  to  treat  patients  using  our  Invisalign  system.  Consequently,  doctors  may  be  unwilling  to  adopt  our  products  until  they  successfully
complete one or more cases or until more historical clinical results are available.
In addition, as part of our effort to accommodate our customers’ needs and demands, we periodically introduce new business and sales initiatives,
such as our commercial teeth whitening products announced in 2021. In general, our internal resources support these new businesses or sales initiatives,
and we frequently provide such support without clear indications it will prove successful or be without short-term execution challenges.
As  we  continue  to  grow,  we  are  subject  to  growth  related  risks,  including  risks  related  to  excess  or  constrained  capacity  and  operational
inefficiencies at our manufacturing and treat facilities.
We  are  subject  to  growth  related  risks,  including  excess  or  constrained  capacity  and  pressure  on  our  internal  systems,  personnel  and  suppliers.  In
order  to  manage  current  operations  and  future  growth  effectively,  we  must  continue  implementing  and  improving  our  operational,  financial  and
management  information  systems,  hire,  train,  motivate,  manage  and  retain  employees,  and  ensure  our  suppliers  remain  diverse  and  capable  of  meeting
growing demand for the systems, raw materials, parts and components essential to the manufacture and delivery of our products. We may be unable to
manage  such  growth  effectively  while  balancing  near-term  efforts  to  meet  existing  demand,  including  adding  personnel,  creating  scalable,  secure  and
robust systems and operations, and automating processes needed for long term efficiencies. Any such failure could have a material adverse impact on our
business, operations and prospects.
We continue to establish treatment planning and manufacturing facilities closer to our international customers in order to provide them with better
experiences, improve their confidence in using the Invisalign system and iTero intraoral scanners to treat more patients, and provide redundancy should
other facilities be temporarily or permanently unavailable. Our ability to obtain regulatory clearance and certifications for, move into, plan, construct and
equip additional facilities is subject to significant risk and uncertainty, including risks related to establishing facilities, hiring and retaining employees and
delays  and  cost  overruns,  any  of  which  may  be  all  or  partially  out  of  our  control  and  can  negatively  impact  our  gross  margin.  In  addition,  operating
facilities located in higher cost regions compared to Mexico, China and Costa Rica negatively impacts our gross margin. If the construction or transition
into  additional  facilities  is  significantly  delayed,  if  a  facility  is  required  to  temporarily  or  permanently,  partially  or  fully  shut  down,  or  demand  for  our
products outpaces our ability to hire qualified personnel and effectively implement systems and infrastructure, we may be unable to fulfill orders timely, or
at all, which may negatively impact our financial results, reputation and overall business.
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In addition, because adapting production capacity and related cost structures to changing market conditions takes time, our facilities’ capacity may at
times exceed or fall short of our production requirements. For instance, as a result of the COVID-19 pandemic, sales in the final weeks of the first quarter
of 2020 declined substantially and operations at our manufacturing facilities declined shortly thereafter. Then, as dental practices reopened we experienced
a rapid increase in demand. These fluctuations in demand and sales have recurred several times since the first quarter of 2020 corresponding with increases
in  the  number  of  people  infected  with  COVID-19  and  variants  such  as  Delta  and  Omicron,  and  may  continue  to  arise  in  the  future.  If  product  demand
decreases or increases more than forecast, we could be required to write off inventory or record excess capacity charges, we may be required to purchase or
lease additional or larger facilities and additional equipment, or we may be unable to fulfill customer demand in the time frames and with the quantities
required,  any  of  which  may  take  time  to  accomplish,  lower  our  gross  margin,  inhibit  sales  or  harm  our  reputation.  Additionally,  if  we  are  required  to
implement  new  or  modify  existing  health  and  safety  protocols  to  safeguard  our  employees,  customers  or  their  patients,  productivity  could  decline.
Production  of  our  clear  aligners  and  intraoral  scanners  are  also  limited  by  capacity  constraints  due  to  a  variety  of  factors,  including  labor  shortages,
shipping delays, our dependency on third-party vendors for key materials, parts, components and equipment, and limited production yields. Any or all of
these problems could result in the loss of customers, provide an opportunity for competing products to gain market acceptance and otherwise harm our
business and financial results.
Our  products  and  information  technology  systems  are  critical  to  our  business.  Issues  with  product  development  or  enhancements,  IT  system
integration, implementation, updates and upgrades along with security and data protection risks have previously and could again in the future disrupt
our operations, which could have a material adverse impact on our business and operating results.
We rely on the efficient, uninterrupted and secure operation of our own complex information technology systems (“IT systems”) and are dependent on
key software of third parties embedded in our products and IT systems as well as third-party hosted IT systems to support our operations. All software and
IT systems are vulnerable to damage, attack or interruption from a variety of sources. As our business has grown in size and complexity, including through
the integration of acquired businesses, which to date have been smaller organizations with less-mature or less sophisticated systems, securities practices or
training, the growth has placed, and will continue to place, significant demands on our operations and such systems and have increased the risk of security
incidents.  To  effectively  manage  our  existing  operations  and  continue  to  grow,  our  IT  systems  and  applications  require  an  ongoing  commitment  of
significant  resources  to  maintain,  protect,  enhance  and  restore  existing  systems  and  develop  new  systems  to  keep  pace  with  continuing  changes  in
information  processing  technology,  evolving  industry  and  regulatory  standards,  increasingly  sophisticated  cyber  threats,  and  changing  customer
preferences. Expanded remote working and increased usage of online and hosted technology platforms by us, our customers and suppliers have increased
the demands on and risks to our IT systems and personnel. Moreover, we continue to transform certain business processes, extend established processes to
new subsidiaries and/or implement additional functionality in our enterprise resource planning (“ERP”), product development, manufacturing, and other
software and IT systems which entails certain risks, including disruption of our operations, such as our ability to develop and update products that are safe
and secure, track orders and timely ship products, manage our supply chain and aggregate financial and operational data.
System  upgrades,  development  of  new  releases  and  enhancements  require  significant  expenditures  and  allocation  of  valuable  employee  resources.
Delays in integration or disruptions to our business from implementation of these new or upgraded systems could have a material adverse impact on our
financial condition and operating results.
Additionally, we continuously upgrade and issue new releases of our products and customer facing software applications, such as our iTero intraoral
scanners, exocad CAD/CAM solutions, my iTero, our ClinCheck software, MyAligntech and the Invisalign Doctor Site as well as our internal software
applications upon which customer facing, manufacturing and treatment planning operations are dependent. Software applications and products containing
software  frequently  contain  errors  or  defects,  especially  when  first  introduced  or  when  new  versions  are  released.  Additionally,  the  third-party  software
integrated  into  or  interoperable  with  our  products  and  services  will  routinely  reach  end  of  life,  and  as  a  consequence,  certain  models  of  our  intraoral
scanners  may  be  exposed  to  additional  vulnerabilities,  including  increased  security  risks,  errors  and  malfunctions  that  may  be  irreparable  or  difficult  to
repair.  The  discovery  of  a  defect,  error  or  security  vulnerability  in  our  products,  software  applications  or  IT  systems,  incompatibility  with  customers’
computer operating systems and hardware configurations with a new release or upgraded version or the failure of our products or primary IT systems may
cause  adverse  consequences,  including:  delay  or  loss  of  revenues,  significant  remediation  costs,  delay  in  market  acceptance,  loss  of  data,  disclosure  of
financial,  health  or  other  personal  information  of  our  customers  or  their  patients,  product  recalls,  damage  to  our  reputation,  loss  of  market  share  or
increased service costs, any of which could have a material adverse effect on our business, financial condition or results of operations.
A significant portion of our clear aligner production is dependent on digital scans from our iTero and third-party intraoral scanners. Failures of all or
any portion of ours or third-party software or other components or systems to interoperate with iTero
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or  third-party  scanners,  termination  of  interoperability  with  third-party  scanners,  malware  or  ransomware  attacks,  product  or  system  vulnerabilities  or
defects,  or  a  system  outage  for  any  reason  have  harmed  our  operations  previously  and  in  the  future  could  affect  materially  and  adversely  our  ability  to
accept scans, manufacture clear aligners or restorative procedures or treatments and services or otherwise service our customers which may, amongst other
things, harm our sales, damage our reputation, adversely impact our strategic partners or result in litigation.
Additionally,  our  globally-dispersed  installed  base  of  iTero  intraoral  scanners  at  customer,  strategic  business  partner  or  other  locations  may  be
independently or collectively the target of a cybersecurity incident or attack or subject to the intrusion of a virus, bug, or other similar negative intruder.
Due to the large and growing number of these decentralized locations, we may not be able to, or not have the capacity, knowledge, or infrastructure to,
respond to or remedy a cybersecurity issue in a timely manner or sufficiently, either of which may cause loss or damage to us or our customers or strategic
business partners or may cause further malfunctions in, or damage to, our servers, databases, systems or products and services, loss or damage of our data,
interruption or temporary cessation of our operations, or an overall negative impact to our business or reputation.
If  the  information  we  rely  on  to  run  our  businesses  is  inaccurate  or  unreliable,  or  if  the  data  governance  controls  in  place  fail  or  change,  or  if
compliance with such controls fails, or if we fail to properly maintain, secure or restore our IT systems, or if the integrity of our products or IT systems is
compromised  or  questioned  or  data  is  lost,  or  if  we  fail  to  develop  new  capabilities  to  meet  our  business  needs  in  a  timely  manner,  we  could  suffer
operational disruptions, have customer disputes, and fail to produce timely, accurate or complete reports. We may also be required to respond to regulatory
inquiries or actions, forced to defend against litigation or pay damages, penalties or fines, experience increases in operating and administrative expenses,
find  it  necessary  to  recall  or  repair  products,  rebuild  networks  or  systems,  lose  existing  customers  or  strategic  business  partners,  experience  difficulties
attracting new customers or implementing our growth strategies, or suffer other adverse consequences. In addition, experienced computer programmers and
hackers  may  be  able  to  penetrate  the  security  features  of  our  products,  IT  systems  or  our  cloud-based  software  servers  hosted  by  third  parties  and
misappropriate, destroy or damage our confidential information or that of third parties, expose health, financial data, or other personal information of our
customers  and  their  patients,  create  system  disruptions  or  cause  shutdowns.  Furthermore,  sophisticated  hardware  and  operating  system  software  and
applications that we either internally develop or procure from third parties may contain defects or present risks in design, development, manufacture or
distribution, including “bugs,” security vulnerabilities, and other problems that can unexpectedly interfere with the operation of the system or compromise
or exploit the safety and security of our products, networks or data. The costs to eliminate, mitigate or recover from security problems, viruses and bugs
could  be  significant  and  depending  on  the  nature  and  extent  of  the  problem  and  the  networks  or  products  impacted,  may  result  in  network  or  systems
interruptions, decreased product sales, or data loss that may have a material adverse impact on our operations, net revenues and operating results.
There can be no assurance that our process of improving existing or developing new products or IT systems, integrating new IT systems, protecting
confidential patient health information, and improving service levels will not be delayed or that additional product or IT systems issues will not arise in the
future.  Failure  to  adequately  protect  and  maintain  the  integrity  of  our  products  and  IT  systems  and  data  may  result  in  a  material  adverse  effect  on  our
financial position, results of operations and cash flows.
If we are unable or fail to protect our customer or patient information or if we are unable to comply with applicable privacy, security and data
protection laws, our operations may be severely adversely impacted, patient care could suffer, we could be liable for related damages, and our business,
operations and reputation could be harmed.
We retain confidential customer financial as well as patient health information in addition to our own proprietary information and data essential to our
business  operations.  Therefore,  it  is  critical  that  the  facilities  and  infrastructure  on  which  we  depend  to  run  our  business  and  the  products  we  develop
remain secure and are also perceived by the marketplace and our customers to be secure. Despite the implementation of security features in our products
and security measures in our IT systems, our products as well as the infrastructure and IT systems on which we depend are vulnerable to physical break-ins,
computer viruses, programming errors or other technical malfunctions, hacking or phishing attacks by third parties, malware and ransomware, employee
error or malfeasance or similar disruptive problems. For example, we have experienced cybersecurity incidents and may again in the future. Further, the
frequency  of  third-party  cyber  attacks  has  increased  since  the  onset  of  the  COVID-19  pandemic.  Significant  service  disruptions,  breaches  in  our
infrastructure  and  IT  systems  or  other  cybersecurity  incidents  could  expose  us  to  litigation  or  regulatory  investigations,  impair  our  reputation  and
competitive position, be distracting to our management, and require significant time and resources to address. Affected parties or regulatory agencies could
initiate legal or regulatory action against us, which could prevent us from resolving the issues quickly or in unanticipated ways, cause us to incur significant
expense  and  liability,  or  result  in  judicial  or  governmental  orders  forcing  us  to  cease  operations  or  modify  our  business  practices  in  ways  that  could
materially limit or restrict the products and services we provide. Concerns over our privacy practices could adversely affect others’ perception of us and
deter customers, patients and partners from using our products. In addition, patient care could suffer, and we could be liable if our products or IT systems
fail
25
to deliver accurate and complete information in a timely manner. We have cybersecurity and other forms of insurance coverage related to a breach event
covering expenses for notification, credit monitoring, investigation, crisis management, public relations and legal advice. The policy also provides coverage
for regulatory action defense including oversight, investigations and disclosure obligations as well as fines and penalties, potential payment card industry
fines and penalties and costs related to cyber extortion; however, damages and claims arising from such incidents may not be covered or may exceed the
amount of any coverage and do not cover the time and effort we incur investigating and responding to any incidents, which may be significant.
We  are  also  subject  to  federal,  state  and  foreign  laws  and  regulations,  including  ones  relating  to  privacy,  data  security  and  protection,  content
regulation, and consumer protection among others. We are subject to various national and regional data localization or data residency laws which generally
require that certain types of data collected within a country be stored and processed only within that country or approved countries and other countries are
considering enacting similar data localization or data residency laws. We have and likely will again in the future be required to implement new or expand
existing data storage protocols, build new storage facilities, and/or devote additional resources to comply with such laws, any of which could be costly. We
are  also  subject  to  data  export  restrictions  and  international  transfer  laws  which  prohibit  or  impose  conditions  upon  the  transfer  of  such  data  from  one
country  to  another.  These  laws  and  regulations  are  constantly  evolving  and  may  be  interpreted,  applied,  created  or  amended  in  a  manner  that  could
adversely affect our business.
In addition, we must comply with numerous data privacy and data security requirements that span from individual state and national laws in the U.S.
and China to multinational requirements in the EU. For instance, China has enacted complex and highly restrictive cybersecurity, data localization, and
cross  border  data  transfer  laws.  In  the  EU,  we  must  comply  with  the  General  Data  Protection  Regulation  which  serves  as  a  harmonization  of  EU  data-
privacy laws, and in the U.S., we must comply with data privacy and data security provisions of the U.S. Health Insurance Portability and Accountability
Act  regulations.  Moreover,  the  number  of  local  and  national  governments  enacting  data  privacy  laws  continues  to  increase  and  we  expect  this  trend  to
continue.  Maintaining  compliance  with  these  laws  and  regulations  is  costly  and  could  require  complex  changes  in  the  way  we  do  business  or  provide
services  to  our  customers  and  their  patients.  Additionally,  our  success  may  be  dependent  on  the  success  of  healthcare  providers,  many  of  whom  are
comprised of individual or small operations with limited IT experience and inadequate or untested security protocols, in managing data privacy and data
security requirements.
If we fail to sustain or increase revenue growth while controlling expenses, our profitability may decline.
If we are to sustain or increase profitability in future periods, we need to continue increasing our net revenues while controlling expenses. Because
our business and the markets we target are evolving, it is difficult to predict our future operating results or levels of growth or declines. We have not in the
past and may be unable in the future to sustain or regain our historical growth rates which may cause our profitability to decline.
Our operating results have and will continue to fluctuate in the future, which makes predicting the timing and amount of our revenues, costs and
expenditures difficult.
Our quarterly and annual operating results have and will continue to fluctuate for a variety of reasons, including as a result of changing doctor and
consumer product demand. Some of the factors that have historically and in the future could cause our operating results to fluctuate include:
•
•
limited visibility into, and difficulty predicting from quarter to quarter, the types of procedures and level of activities in our customers’ practices;
fluctuations in the number of patients seeking treatment and the number of doctors providing services and treatment as a result of the pandemic
and new variants in the virus;
changes in demand based on geographies, channels, or product mix;
the level of confidence of doctors in our products and changes in the rates at which they recommend or utilize our products for their patients;
•
•
• weakness in consumer spending and confidence, inflation, a slowdown or recession in domestic or international economies;
• higher manufacturing, delivery and inventory costs;
• unanticipated  delays  and  disruptions  in  the  manufacturing  process  caused  by  insufficient  capacity  or  availability  of  raw  materials,  parts  or
components, shortages or turnover in the labor force or the introduction of new production processes, power outages or insufficient power, natural
or other disasters, pandemics or general economic conditions impacting the solvency of vendors in our supply chain;
competition in general and competitive developments in our target markets;
•
26
• new programs or business models, new product or services introductions or changes or modifications to existing products and services offerings,
•
•
including any impacts related to the timing of orders, product mix or market cannibalization;
changes in relationships with DSOs and distributors, including the timing of orders;
changes in the timing of revenue recognition and changes in our average selling prices, including as a result of the timing of receipt of product
orders and shipments, product and services mix, geographic mix, product and services deferrals, the introduction of new products and software
releases, product pricing, bundling and promotions, pricing for fees or expenses, modifications to our terms and conditions such as payment terms,
or as a result of new accounting pronouncements or changes to critical accounting estimates including, without limitation, those estimates based
on such matters as our predicted usage of additional aligners;
the creditworthiness, liquidity and solvency of our customers and their ability to timely make payments when due;
fluctuations in currency exchange rates against the U.S. dollar;
•
•
• our inability to scale, suspend or reduce production and treatment operations based on variations in product demand;
•
seasonal fluctuations, including those related to patient demographics such as the seasonality of teen treatments in the U.S., China and Europe as
well as the number of doctors in their offices and their availability to take appointments;
costs  and  expenditures  in  connection  with  such  things  as  the  establishment  of  new  treatment  planning  and  fabrication  facilities,  the  hiring  and
deployment of personnel, and litigation, and the success of or changes to our marketing programs from quarter to quarter;
timing and fluctuation of spending around marketing and brand awareness campaigns and industry trade shows;
•
• our reliance on our contract manufacturers for the production of sub-assemblies for our intraoral scanners;
•
•
• major  changes  in  available  technology  or  the  preferences  of  customers  may  cause  our  current  product  offerings  to  become  less  competitive  or
increased advertising or marketing efforts or aggressive price competition from competitors;
changes to our effective tax rate;
•
obsolete;
• unanticipated delays or disruptions in our receipt of patient records made through intraoral scanners for any reason;
• disruptions to our business due to political, economic or other social instability or any governmental regulatory or similar actions, including the
impact  of  epidemics  and  pandemics  such  as  COVID-19,  any  of  which  results  in  changes  in  consumer  spending  habits,  limiting  or  restricting
patient visits to orthodontists or general practitioners, as well as any impact on workforce absenteeism;
inaccurate forecasting of net revenues, production and other operating costs;
investments in research and development to develop new products and enhancements; and
•
•
• material impairments of goodwill and long-lived assets.
To respond to these and other factors, we may make business decisions that adversely affect our operating results such as modifications to our pricing
policy and payment terms, promotions, development efforts, product releases, business structure or operations. Most of our expenses, such as employee
compensation and lease obligations, are relatively fixed in the short term. Moreover, our expense levels are based, in part, on our expectations for future
revenues. As a result, if our net revenues for a particular period fall below expectations, we may be unable to timely or effectively reduce spending to offset
any shortfall in net revenues. Due to these and other factors, we do not believe that quarter-to-quarter comparisons of our operating results are meaningful.
A disruption in the operations of a primary freight carrier, higher shipping costs or shipping delays could disrupt our supply chain and cause a
decline in our net revenues or a reduction in our earnings.
We  are  dependent  on  commercial  freight  carriers,  primarily  UPS,  to  deliver  our  products.  If  the  operations  of  these  carriers  are  disrupted  for  any
reason, we may be unable to timely deliver our products to our customers who may choose alternative products causing our net revenues and gross margin
to decline, possibly materially. When fuel costs increase, our freight costs generally do so as well. In addition, we earn an increasingly larger portion of our
total  revenues  from  international  sales.  International  sales  carry  higher  shipping  costs  which  could  negatively  impact  our  gross  margin  and  results  of
operations. If freight costs materially increase and we are unable to successfully pass all or significant portions of the increase along to our customers, or
we cannot otherwise offset such increases in our cost of net revenues, our gross margin and financial results could be adversely affected.
If we fail to accurately predict our volume growth, hire too many or too few technicians, or manufacture too many or too few products, the delivery
time for our products could be delayed or our costs may exceed our revenues, each of which could adversely affect our results of operations.
If  we  fail  to  accurately  predict  our  volume  growth,  we  may  inaccurately  estimate  the  staffing,  materials  or  storage  required  to  manufacture  our
products.  If  we  underestimate  volume  growth,  our  growth  may  exceed  our  manufacturing  capacity  of  one  or  more  of  our  suppliers  or  manufacturing
facilities, we may be understaffed and we may not have sufficient materials.
27
Specifically,  our  manufacturing  process  relies  on  sophisticated  computer  software  and  requires  new  technicians  to  undergo  a  relatively  long  training
process, often 120 days or longer. As a result, if we are unable to accurately predict our volume growth, we may have an insufficient number of trained
technicians to ensure products are manufactured and delivered within the time frames our customers expect. Without sufficient capacity, trained personnel
or materials, we may be unable to provide our products to customers in a timely manner, which could damage our relationships with our existing customers
or  harm  our  ability  to  attract  new  customers.  This  could  cause  a  decline  in  our  net  revenues  and  net  income  and  could  adversely  affect  our  results  of
operations.
Conversely, if we over estimate our growth, we may have excess expenses caused by excess staffing, materials, and capacity. If we hire and train too
many technicians in anticipation of volume growth that does not materialize, materializes at a rate slower than anticipated, or if volumes decline, our costs
and expenditures may outpace our revenues or revenue growth, harming our gross margin and financial results. Additionally, in order to secure supplies for
production of products, we sometimes enter into non-cancelable minimum purchase commitments with vendors, which could impact our ability to adjust
our inventory to reflect declining market demands. If demand for our products is less than we expect, we may experience additional excess and obsolete
inventories and be forced to incur additional charges and our profitability may suffer.
We are dependent on our marketing activities to deepen our market penetration and raise awareness of our brand and products, which may not
prove successful or may become less effective or more costly to maintain in the long term.
Our marketing efforts and costs are significant and include national and regional campaigns in multiple countries involving television, print media,
social media and, more recently, alliances with professional sports teams, social media influencers and other strategic partners. We attempt to structure our
advertising  campaigns  to  increase  brand  awareness,  adoption  and  goodwill;  however,  there  is  no  assurance  our  campaigns  will  achieve  the  returns  on
advertising  spend  desired,  increase  brand  or  product  awareness  sufficiently  to  sustain  or  increase  our  growth  goals  or  generate  goodwill  and  positive
reputational goals. Moreover, should any entity or individual endorsing us or our products take actions, make or publish statements in support of, or lend
support to events or causes which may be perceived by all or any portion of society negatively, our sponsorships or support of these entities or individuals
may be called into question, boycotts of our products announced, and our reputation may be harmed, any of which could have an adverse effect on our
gross margin and business overall.
In addition, various countries prohibit certain types of marketing activities. For example, some countries restrict direct to consumer advertising of
medical devices. We could run afoul of restrictions and be ordered to stop certain marketing activities. Moreover, competitors do not always follow these
restrictions, creating an unfair advantage and making it more difficult and costly for us to compete.
Additionally,  we  rely  heavily  on  data  generated  from  our  campaigns  to  target  specific  audiences  and  evaluate  their  effectiveness,  particularly  data
generated from internet activities on mobile devices. To obtain this data, we are dependent on third parties and popular mobile operating systems, networks,
technologies, products, and standards that we do not control, such as the Android and iOS operating systems and mobile browsers. Any changes in such
systems that degrade, reduce or eliminate our ability to target or measure the results of ads or increase costs to target audiences could adversely affect the
effectiveness of our campaigns. For example, Apple has released mobile operating systems that include significant data privacy changes that may limit our
ability to interpret, target and measure ads effectively.
Our success depends in part on our proprietary technology, and if we fail to successfully obtain or enforce our intellectual property (“IP”) rights,
our competitive position may be harmed. Litigating claims of this type is costly and could distract our management and cause a decline in our results of
operations and stock price.
Our  success  depends  in  part  on  our  ability  to  maintain  existing  IP  rights  and  to  obtain  and  maintain  further  IP  protection  for  our  products.  Our
inability to do so could harm our competitive position.
We rely on our portfolio of issued and pending patent applications in the U.S. and other countries to protect a large part of our IP and our competitive
position;  however,  these  patents  may  be  insufficient  to  protect  our  IP  rights  because  our  patents  may  be  challenged,  invalidated,  held  unenforceable,
circumvented, or may not be sufficiently broad to prevent third parties from producing competing products similar in design to our products and foreign
patents protections may be more limited than those provided under U.S. patents and IP laws.
We may not be afforded the protection of a patent if our currently pending or future patent filings do not result in the issuance of patents or we fail to
apply for patent protection. We may fail to apply for a patent if our personnel fail to disclose or recognize new patentable ideas or innovations. Remote
working can decrease the opportunities for our personnel to collaborate, thereby reducing the opportunities for effective invention disclosures and patent
application filings. We may choose not to file a
28
foreign  patent  application  if  the  limited  protections  provided  by  a  foreign  patent  outweigh  the  costs  to  obtain  it.  Our  foreign  patent  portfolio  is  less
extensive than our U.S. portfolio.
We also rely on protection of our copyrights, trademarks, trade secrets, know-how and proprietary information. We generally enter into confidentiality
agreements with our employees, consultants and collaborative partners upon commencement of a relationship with us; however, these agreements may not
provide meaningful protection against the unauthorized use or disclosure of our trade secrets or other confidential information, and adequate remedies may
not exist when unauthorized uses or disclosures occur.
Our  inability  to  maintain  the  proprietary  nature  of  our  technology  through  patents,  copyrights  or  trade  secrets  would  impair  our  competitive
advantages  and  could  have  a  material  adverse  effect  on  our  operating  results,  financial  condition  and  future  growth  prospects.  In  particular,  a  failure  to
protect our IP rights might allow competitors to copy our technology or create counterfeit or pirated versions of our products, which could adversely affect
our reputation, pricing and market share.
Litigation, interferences, oppositions, re-exams, inter partes reviews, post grant reviews or other proceedings have been necessary and will likely be
needed in the future to determine the validity and scope of certain of our IP rights and the IP rights claimed by third parties to determine the validity, scope
or  non-infringement  of  certain  patent  rights  pertinent  to  the  manufacture,  use  or  sale  of  our  products  and  the  products  of  competitors.  Asserting  or
defending these types of proceedings can be unpredictable, protracted, time consuming, expensive and distracting to management and technical personnel.
The outcome of such proceedings could adversely affect the validity and scope of our patent or other IP rights, hinder our ability to manufacture and market
our  products,  require  us  to  seek  a  license  for  infringing  products  or  technologies  or  result  in  the  assessment  of  significant  monetary  damages.  An
unfavorable  ruling  could  include  monetary  damages,  an  injunction  prohibiting  us  from  selling  our  products,  or  an  exclusion  order  preventing  us  from
importing our products in one or more countries. Moreover, independent actions by competitors, customers or others have been brought alleging that our
efforts  to  assert  or  attempt  to  enforce  our  patent  or  other  IP  rights  constitute  unfair  competition  or  violations  of  antitrust  laws  in  the  U.S.  and  other
jurisdictions  and  investigations  and  additional  litigation  based  on  the  same  or  similar  claims  may  be  brought  in  the  future.  The  potential  effects  on  our
business operations resulting from litigation, whether or not ultimately determined in our favor or settled by us, are costly and could adversely affect our
results of operations and stock price.
If we or any vendors on whose products or services we rely for our products and services infringe the patents or IP rights of other parties or are
subject to a patent infringement claim, our ability to grow our business may be severely limited.
Extensive  litigation  over  patents  and  other  IP  rights  is  common  in  the  medical  device,  optical  scanner,  3D  printing  and  other  technologies  and
industries  on  which  our  products  and  services  are  based.  We  have  been  sued  for  infringement  of  third  parties’  patents  in  the  past  and  we  are  currently
defending patent infringement lawsuits and other legal claims. In addition, we periodically receive letters from third parties drawing our attention to their
patent rights. While we do not believe we infringe upon any valid and enforceable rights that have been brought to our attention, there may be other more
pertinent  rights  of  which  we  are  presently  unaware.  The  defense  and  prosecution  of  IP  lawsuits,  interference  proceedings  and  related  legal  and
administrative  proceedings  could  result  in  substantial  expense  to  us  and  significant  diversion  of  effort  by  our  technical  and  management  personnel.  An
adverse determination in any legal proceeding to which we may become a party could subject us to significant liabilities, exclusion orders or injunctions
that may prevent or limit our rights to sell or import our products in one or more countries. An adverse determination of this nature could require us to seek
licenses from third parties. Licenses may not be available on commercially reasonable terms or at all, in which event, our business would be materially
adversely affected.
Obtaining  approvals  and  complying  with  governmental  regulations,  particularly  those  related  to  personal  healthcare  information,  financial
information,  quality  systems  and  data  privacy,  is  expensive  and  time-consuming,  and  any  failure  to  obtain  or  maintain  approvals  or  comply  with
regulations regarding our products or services or the products and services of our suppliers or customers could materially harm our sales, result in
substantial penalties and cause harm to our reputation.
As a supplier of medical devices and solutions, we and many of our healthcare provider customers, suppliers and distributors are subject to extensive
and frequently changing regulations under numerous federal, state, local and foreign laws, including those regulating:
the storage, transmission and disclosure of medical information and healthcare records;
•
• prohibitions against the offer, payment or receipt of remuneration to induce referrals to entities providing healthcare services or goods or to induce
the order, purchase or recommendation of our products; and
the marketing and advertising of our products.
•
The healthcare market itself is also highly regulated and subject to changing political, economic and regulatory influences. For instance, regulations
affecting the security and privacy of patient healthcare information applicable to healthcare providers
29
and their business associates, such as HIPAA, may require us to make significant and unplanned enhancements of software applications or services, result
in delays or cancellations of orders, or result in the revocation of endorsement of our products and services by healthcare participants. Our critical vendors
and  service  providers  are  similarly  subject  to  various  regulations.  Our  failure  or  the  failure  of  our  suppliers,  customers,  advertisers  and  influencers  to
strictly adhere to clearances or approvals in the labeling, marketing and sales of our products and services could subject us to claims or litigation, including
actions alleging false or misleading advertising, unfair or anti-competitive business practices or other violations of laws or regulations, which may result in
costly investigations, fines, penalties, as well as material judgments, settlements or decrees. There can be no assurance that we will adequately address the
business  risks  associated  with  the  implementation  and  compliance  with  such  laws  or  that  we  will  be  able  to  take  advantage  of  any  resulting  business
opportunities.
Furthermore, in general before we can sell a new medical device or market a new use of or claim for an existing product, we must obtain clearance or
approval to gain market access unless an exemption applies. For instance, in the U.S., FDA regulations are wide ranging and govern, among other things:
• product design, development, manufacturing and testing;
• product labeling;
• product storage;
• pre-market clearance or approval;
complaint handling and corrective actions;
•
advertising and promotion; and
•
• product sales and distribution.
It takes significant time, effort and expense to obtain and maintain FDA clearances or approvals of products and services and there is no guarantee we
will successfully or timely obtain or maintain approvals in all or any of the countries in which we do business now or in the future. In other countries, the
requirements  to  obtain  and  maintain  similar  approvals  may  differ  materially  from  those  of  the  FDA  and  may  require  additional  time  and  expense.
Moreover, these laws may change resulting in additional time and expense or loss of approvals. Additionally, the impact of the COVID-19 pandemic on
normal  governmental  operations  may  delay  our  efforts  to  obtain  and  maintain  approvals,  possibly  significantly.  If  approvals  to  market  our  products  or
services are delayed, whether in the U.S. or other countries, we may be unable to offer them in markets we deem important to our business. Failure or
delays  to  obtain  or  maintain  regulatory  approvals  may  materially  harm  our  domestic  or  international  operations,  and  our  business  as  a  whole  adversely
impacted.
Any  failure  to  comply  with  applicable  regulatory  requirements  could  result  in  enforcement  actions  in  the  U.S.  and  other  countries.  For  example,
enforcement actions by the FDA may include one or more of the following sanctions:
repair, replacement, refunds, recall or seizure of our products;
• warning letters, fines, injunctions, consent decrees and civil penalties;
•
• operating restrictions or partial suspension or total shutdown of production;
•
• withdrawing clearance or pre-market approvals previously granted; and
•
criminal prosecution.
refusing our requests for 510(k) clearance or pre-market approval of new products, new intended uses, or modifications to existing products;
We  and  certain  of  our  vendors  must  also  comply  with  facility  registration  and  product  listing  requirements  of  the  FDA  and  adhere  to  applicable
Quality  System  regulations.  The  FDA  enforces  its  Quality  System  regulations  through  periodic  unannounced  inspections.  Our  failure  to  satisfactorily
correct an adverse inspection finding or to comply with applicable manufacturing regulations could result in enforcement actions, and we may be required
to  find  alternative  manufacturers,  which  could  be  a  long  and  costly  process.  Any  enforcement  action  by  the  FDA  or  foreign  governments  could  have  a
material adverse effect on us.
In addition, while we provide significant training to our personnel, they may not properly adhere to our policies or applicable laws or regulations. If
our employees fail to comply with any or all laws or regulations or our policies or procedures, it could result in violations of laws or regulations and subject
us to harm to our reputation, loss of customers, loss or revenues, or regulatory investigations and actions.
Consequently, if we cannot successfully obtain approval for our products or services or timely and cost-effectively maintain compliance with laws
regulating our products and services, our results of operations and financial condition could be harmed.
30
We are highly dependent on third-party suppliers, some of whom are sole source suppliers, for certain key machines, components and materials,
and our business and operating results could be harmed if supply is restricted or ends or the price of raw materials used in our manufacturing process
increases.
We are highly dependent on our supply chain, particularly manufacturers of specialized scanning equipment, rapid prototyping machines, resin and
other advanced materials, as well as the optics, electronic and other mechanical components of our intraoral scanners.
We maintain single supply relationships for many of these machines and materials. In particular, our CT scanning and stereolithography equipment
used in our aligner manufacturing and many of the critical components for the optics of our scanners are provided by single suppliers. We rely on a single
third-party manufacturer to supply key sub-assemblies for our iTero Element scanner. We purchase the vast majority of our resin and polymer, the primary
raw materials used in our manufacturing process for clear aligners, from a single source. By using single suppliers for materials and manufacturing in a
limited  number  of  locations,  we  risk  multiple  supply  chain  vulnerabilities.  For  example,  damage  or  destruction  of  a  facility  can  materially  disrupt  our
ability to timely deliver key components and materials or products or a supplier could encounter financial, operating or other difficulties, be unable to hire
or  maintain  personnel,  fail  to  timely  obtain  supplies,  fail  to  maintain  manufacturing  standards  or  controls,  or  fail  to  timely  deliver  materials,  parts  or
components. Any one of these occurrences would impact our supply chain.
Restrictions in response to the pandemic and other macroeconomic factors have affected and are expected to continue to affect our supply chain. The
manufacture  of  product  components,  the  final  assembly  of  our  products  and  other  critical  operations  are  concentrated  in  certain  geographic  locations,
including China. A significant portion of our finished goods product distribution occurs through China and EMEA. Each of these areas has been affected
by  the  pandemic  and  has  implemented  measures  to  try  to  contain  its  spread,  including  restrictions  on  manufacturing  facilities,  commerce,  travel,  our
support operations and workforce, and our customers, strategic partners, vendors and suppliers. There is considerable uncertainty regarding the current and
future impact of such measures, including reduced availability or increased cost of air transport, port closures and increased border controls and closures.
Any or all restrictions can limit our manufacturers’ capacity to produce our parts or products and have a material adverse effect on our supply chain.
The  effects  of  climate  change  on  regional  and  global  economies  could  change  the  supply,  demand  or  availability  of  sources  of  energy  or  other
resources  material  to  our  products  and  operations  and  affect  the  availability  or  cost  of  natural  resources  and  goods  and  services  on  which  we  and  our
suppliers rely.
Because of our dependence on our suppliers, changes in one or more of our relationships with them or changes in their circumstances can result in
disruptions  to  the  supply  chain,  which  can  materially  impact  our  business.  For  instance,  we  may  be  unable  to  quickly  establish  or  qualify  replacement
suppliers creating production interruptions, delays and inefficiencies. Finding substitute manufacturers may be expensive, time-consuming or impossible
and  could  result  in  a  significant  interruption  in  the  supply  of  one  or  more  products  causing  us  to  lose  revenues  and  suffer  damage  to  our  customer
relationships.  Technology  changes  by  our  vendors  could  disrupt  access  to  required  manufacturing  capacity  or  require  expensive,  time  consuming
development efforts to adapt and integrate new equipment or processes. In the event of technology changes, delivery delays, labor stoppages or shortages,
or shortages of, or increases in price for these items, sales may decrease and our business and growth prospects may be harmed.
We rely on highly skilled personnel and, if we fail to attract, motivate, train or retain highly skilled personnel, it may be more difficult to grow
effectively and pursue our strategic priorities.
We  are  highly  dependent  on  the  talent  and  effort  of  highly  skilled  employees,  including  orthodontists  and  production  technicians  in  our  treatment
planning facilities, and employees on our clinical engineering, technology development and sales teams. To be successful, we must effectively manage our
growth through our ability to identify, hire, develop, motivate, train and retain these skilled employees as well as personnel throughout our organization.
We provide significant training to our personnel and our business will be impacted if our training fails to properly prepare our personnel to perform
the work required, we are unable to successfully instill technical expertise in new and existing personnel or if our techniques prove unsuccessful or not
cost-effective.
Moreover, for certain roles, this training and experience can make key personnel, such as our sales personnel, highly desirable by competitors and
lead to increased attrition. The loss of the services and knowledge from our highly skilled employees may significantly delay or prevent the achievement of
our development and business objectives and could harm our
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business. For example, it can take up to twelve months or more to train sales representatives to successfully market and sell our products and for them to
establish strong customer relationships.
For more discussion related to our personnel and corporate culture see the risk factor, “We rely on our personnel and, if we fail to attract, motivate or
retain personnel, or if our growth harms our corporate culture, it may be more difficult to grow effectively and pursue our strategic priorities.”
If we are unable to expand our workforce, including key sales and other skilled personnel, retain key personnel or quickly replace personnel with
individuals of equivalent technical expertise and qualifications, our net revenues and our ability to maintain market share could be materially harmed.
We use distributors for a portion of the importation, marketing and sales efforts related to our products and services, which exposes us to risks that
may be harmful to our sales and operations, including that these distributors do not comply with applicable laws or our internal procedures.
In addition to our direct sales force, we have and expect to continue to use distributors to import, market, sell, service and support our products. Our
agreements with these distributors are generally non-exclusive and terminable by either party with little notice. If any of these relationships are terminated
and if alternative distributors must be quickly found and trained in the use, marketing, sales and support of our products and services, our revenues and
ability to sell or service our products in markets key to our growth and expansion could be adversely affected. These distributors may also choose to sell
alternative or competing products or services. In addition, we may be held responsible for the actions of these distributors and their employees and agents
for  compliance  with  laws  and  regulations,  including  fair  competition,  bribery  and  corruption,  trade  compliance,  and  marketing  and  sales  activities.  A
distributor may also affect our ability to effectively market our products in certain foreign countries or regulatory jurisdictions if it holds the regulatory
authorization in such countries or within such regions and causes, by action or inaction, the suspension of such marketing authorization or sanctions for
non-compliance  or  prevents  us  from  taking  control  of  any  such  authorization.  It  may  be  difficult,  expensive,  and  time-consuming  for  us  to  re-establish
market access or regulatory compliance in such cases.
Our business exposes us to potential liability for the quality and safety of our products and services, how we advertise and market those products
and services and how and to whom we sell them, and we may incur substantial expenses or be found liable for substantial damages or penalties if we
are subject to claims or litigation.
Our products and services involve an inherent risk of claims concerning their design, manufacture, safety and performance, how they are marketed
and  advertised  in  a  complex  framework  of  highly  regulated  domestic  and  international  laws  and  regulations,  how  we  package,  bundle  or  sell  them  to
customers who may be private individuals or companies or public entities such as hospitals and clinics and how we train and support doctors, their staffs
and patients who administer or use our products. Moreover, consumer products and services are routinely subject to claims of false, deceptive or misleading
advertising, consumer fraud and unfair business practices. Additionally, we may be held liable if any product we develop or manufacture or services we
offer or perform causes injury or is otherwise found unhealthy. If our products are safe but they are promoted for use or used in unintended or unexpected
ways or for which we have not obtained clearance or approvals (“off-label” usage), we may be investigated, fined or have our products or services enjoined
or approvals rescinded or we may be required to defend ourselves in litigation. Although we maintain insurance for product liability, business practices and
other types of activities we make or offer, coverage may not be available on acceptable terms, if at all, and may be insufficient for actual liabilities. Any
claim for product liability, sales, advertising and business practices, regardless of its merit or eventual outcome, could result in significant legal defense
costs and damage our reputation, increase our expenses and divert management’s attention.
Compliance with current or future environmental, social, and governance (“ESG”) laws may materially increase our costs, expose us to potential
liability and otherwise materially impact our business.
Our operations are subject to a variety of existing local, regional and global ESG laws and regulations, and we will likely be required to comply with
new,  broader,  more  complex  and  costly  laws  and  regulations  that  focus  on  ESG  matters  in  the  future.  Our  compliance  obligations  will  likely  span  all
aspects of our business and operations, including product design and development, materials sourcing and other procurement activities, energy and natural
resources usage, facilities design and utilization, recycling and collection, transportation, disposal activities and workers’ rights.
The  environmental  regulations  related  to  greenhouse  gases  may  have  an  impact  on  our  or  our  suppliers’  energy  sources.  Many  U.S.  and  foreign
regulators have enacted or are considering enacting new or additional limits on the emissions of greenhouse gases, including, but not limited to, carbon
dioxide and methane, from power generation units using fossil fuels like
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coal and natural gas. The effects of greenhouse gas emission limits on power generation that have been enacted already or that may be enacted in the future
are subject to significant uncertainties, including the timing of any new requirements and levels of emissions reductions. Initiatives and legislation designed
to reduce, restrict or eliminate greenhouse gas emissions from power generation may have the effect of increasing our costs and those of our suppliers and
could  result  in  manufacturing,  transportation  and  supply  chain  disruptions  and  delays  if  clean  energy  alternatives  are  not  readily  available  in  adequate
supply when required. Moreover, alternative energy sources that supply the power to meet our current and future demands as well as those of our suppliers
and the global and regional economies in general, coupled with reduced investments in traditional energy sources and infrastructure, may fail to provide the
predictable, reliable, and consistent energy that we, our suppliers and other businesses need for operations.
Regulations related to sourcing of certain metals may have an impact on our business. For instance, the sourcing and availability of metals that may
be used in the manufacture of, or contained in, our products may be affected by laws and regulations in the U.S. or internationally regarding the use of
minerals obtained from certain regions of the world like the Democratic Republic of Congo and adjoining countries. Although we do not believe that we or
our suppliers source minerals from this region, these laws and regulations may decrease the number of suppliers capable of supplying our needs for certain
metals, thereby negatively affecting our ability to manufacture products in sufficient quantities or at competitive prices, leading customers to potentially
choose competitive goods and services.
Meeting our obligations under existing laws, rules, or regulations is already costly to us and our suppliers, and we expect those costs to increase in the
future, possibly materially. Additionally, we expect regulators to perform investigations, inspections and periodically audit our compliance with these laws
and regulations, and we cannot provide assurance that our efforts or operations will be compliant. If we fail to comply with any requirements, we could be
subject to significant penalties or liabilities and we may be required to implement new and significantly more costly processes and procedures to come into
compliance. Further these laws are subject to unpredictable changes. Even if we successfully comply with these laws and regulations, our suppliers may
fail to comply. We may also suffer financial and reputational harm if customers require, and we are unable to deliver, certification that our products are
conflict  free.  In  all  of  these  situations,  customers  may  stop  purchasing  products  from  us,  and  may  take  legal  action  against  us,  which  could  harm  our
reputation, revenues and results of operations.
General Risk Factors
We rely on our personnel and, if  we  fail  to  attract,  motivate  or  retain  personnel,  or  if  our  growth  harms  our  corporate  culture,  it  may  be  more
difficult to grow effectively and pursue our strategic priorities.
We believe a key factor in our success has been the culture we have created that emphasizes a shared vision and values focusing on agility, customer
success and accountability. We believe this culture fosters an environment of integrity, innovation, creativity, and teamwork. We have also experienced in
the past and expect to experience in the future, difficulties attracting and retaining employees that meet the qualifications, experience, compliance mindset
and values we expect. If we are unable to attract and retain personnel that meet our selection criteria or relax our standards in order to meet the demands of
our  growth  or  if  our  growth  is  not  managed  effectively,  our  corporate  culture,  ability  to  achieve  our  strategic  objectives,  and  our  compliance  with
obligations under our internal controls and other requirements may be harmed.
We are considering adjusting our remote working policies, which may cause our culture to change, cause us to incur additional costs, or cause us to
lose talent or fail to attract talent. Many of our employees have worked remotely during the COVID-19 pandemic, which makes it difficult to maintain or
enhance  our  culture,  especially  for  new  employees  onboarded  remotely.  As  we  evaluate  when  and  how  to  return  employees  to  our  offices  globally,  we
continue to assess the impact various return-to-office plans may have on our culture, morale, and hiring and retention, particularly considering tight labor
markets and generous or broad remote working policies being adopted by companies against whom we compete for talent. Should we choose to require
employees  to  return  to  the  office,  implement  or  modify  a  remote  working  policy,  and/or  allow  or  modify  a  hybrid  approach  in  which  employees  can
continue  to  work  from  home  or  other  remote  locations  on  a  limited  or  part  time  basis  only,  it  may  materially  increase  our  costs  or  create  unforeseen
challenges or complications, including:
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difficulties maintaining our corporate culture, disruption of morale or decreased loyalty;
negative impacts to collaboration, performance and productivity;
increased employee stress, fatigue or “burn out” by employees unable to disengage their work life from the home life;
increased operational, governance, compliance, and tax risks;
increased attrition or limits to our ability to attract employees who prefer for convenience or for safety reasons to continue working remotely full
time, or in offices or geographies different from where they were hired to work or are expected to work;
problems managing office space requirements;
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concerns regarding favoritism or discrimination;
strains to our business continuity plans and difficulties achieving our strategic objectives; and
increased labor and employment claims and litigation.
Furthermore,  our  compensation  and  benefit  arrangements,  such  as  our  equity  award  programs,  may  not  always  be  successful  in  attracting  new
employees and retaining and motivating existing employees. In addition, other internal and external factors can impact our ability to hire and retain talent,
including insufficient advancement or career opportunities, restrictive immigration policy and regulatory changes, an increase in employees choosing to
retire or quit with no immediate intentions to continue working and significantly higher demand for technical and digital talent.
If we are unable to attract and retain personnel that meet our selection criteria or relax our standards in order to meet the demands of our growth or if
our  growth  is  not  managed  effectively,  our  corporate  culture,  ability  to  achieve  our  strategic  objectives,  and  our  compliance  with  obligations  under  our
internal controls and other requirements may be harmed.
Business disruptions could seriously harm our financial condition.
Our global operations have been disrupted in the past and will likely be disrupted and harmed again in the future. The occurrence of any material or
prolonged business disruptions could harm our growth and expansion, result in significant losses, seriously harm our revenues, profitability and financial
condition, adversely affect our competitive position, increase our costs and expenses, and require substantial expenditures and recovery time in order to
fully resume operations.
Human error can have a significant effect on our business. While we train our employees and perform our due diligence when contracting with third
parties, mistakes and accidents still occur. For instance, in March 2021, a container ship carrying some of our products was stuck in the Suez Canal for six
days. Although this did not have a material adverse effect on our business, there is no assurance that such incidents may not impact us in a material way in
the future.
Natural  disasters  can  impact  our  business,  including  as  a  result  of  earthquakes,  tsunamis,  floods,  droughts,  hurricanes,  wildfires,  extreme  weather
conditions, power outages, restrictions and shortages, telecommunications failures, materials scarcity and price volatility, and medical epidemics or health
pandemics. Climate change is likely to increase both the frequency and severity of natural disasters and, consequently, risks to our operations and growth.
Our digital dental modeling and certain of our customer facing operations are primarily processed in our facilities located in Costa Rica. Our aligner molds
and finished aligners are fabricated in Mexico and China. Our locations in Costa Rica and Mexico as well as others are in earthquake zones and may be
subject to other natural disasters. Moreover, a significant portion of our research and development activities are located in California, which suffers from
earthquakes, periodic droughts, power shortages and wildfires. If there is a major earthquake or any other natural disaster in a region where one of these
facilities is located, our employees could be impacted, our research could be lost, and our ability to create ClinCheck treatment plans, respond to customer
inquiries or manufacture and ship our aligners could be compromised which could result in our customers experiencing significant delays receiving their
aligners and a decrease in service levels.
When  human  induced  or  natural  disasters  occur,  they  may,  individually  or  in  the  aggregate,  affect  our  ability  to  provide  products,  services  and
solutions to our customers, and could cause production delays or limitations, create adverse effects on distributors, disrupt supply chains, result in shipping
and  distribution  disruptions  and  reduce  the  availability  of  or  access  to  one  or  more  facilities,  any  of  which  could  materially  and  adversely  affect  our
business, financial condition and results of operations.
Changes in, or interpretations of, accounting rules and regulations, could result in unfavorable accounting charges.
We  prepare  our  consolidated  financial  statements  in  conformity  with  U.S.  GAAP.  These  principles  are  subject  to  interpretation  by  the  SEC  and
various bodies formed to interpret and create appropriate accounting policies. A change in these policies or in the way these policies are interpreted by us or
regulators can have a significant effect on our reported results and may even retroactively affect previously reported transactions.
We are required to annually assess our internal control over financial reporting and any adverse results from such assessment may result in a loss
of investor confidence in our financial reports and have an adverse effect on our stock price.
We are required to furnish in our Form 10-K a report by our management regarding the effectiveness of our internal control over financial reporting
that  includes,  among  other  things,  an  assessment  of  the  effectiveness  of  our  internal  control  over  financial  reporting  as  of  the  end  of  our  fiscal  year,
including  a  statement  as  to  whether  our  internal  control  over  financial  reporting  is  effective.  Our  internal  controls  may  become  inadequate  because  of
changes in personnel, updates and upgrades to existing software including our ERP software system, changes in accounting standards or interpretations of
existing standards,
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and, as a result, the degree of compliance of our internal control over financial reporting with the existing policies or procedures may become ineffective.
Establishing, testing and maintaining an effective system of internal control over financial reporting requires significant resources and time commitments
on  the  part  of  our  management  and  our  finance  staff,  may  require  additional  staffing  and  infrastructure  investments  and  increases  our  costs  of  doing
business. If we are unable to assert that our internal control over financial reporting is effective in any future period (or if our auditors are unable to express
an opinion on the effectiveness of our internal controls or conclude that our internal controls are ineffective), the timely filing of our financial reports could
be  delayed  or  we  could  be  required  to  restate  past  reports,  and  cause  us  to  lose  investor  confidence  in  the  accuracy  and  completeness  of  our  financial
reports in the future, which could have an adverse effect on our stock price.
We are exposed to fluctuations in currency exchange rates and inflation, each of which could negatively affect our financial condition and results
of operations.
Although the U.S. dollar is our reporting currency, a growing portion of our net revenues and net income are generated in foreign currencies. Net
revenues  and  net  income  generated  by  subsidiaries  operating  outside  of  the  U.S.  are  translated  into  U.S.  dollars  using  constantly,  often  substantially,
fluctuating exchange rates. As a result, negative movements in exchange rates against the U.S. dollar have and may increasingly adversely affect our net
revenues and net income in our consolidated financial statements. We enter into currency forward contract transactions in an effort to cover some of our
exposure to currency fluctuations, but there is no assurance these transactions will fully or effectively hedge our exposure to currency fluctuations, and,
under certain circumstances, these transactions could have an adverse effect on our financial condition.
We also experienced rising inflationary pressures in 2021 and expect such pressures to continue in 2022. Cost inflation, including increases in ocean
container rates, raw material prices, labor rates, and domestic transportation costs threaten to impact our profitability and our ability to recover these cost
increases through price increases may continue to lag, resulting in downward pressure on our gross margin and operating margin. Any attempts to offset
cost increases with price increases may result in reduced sales, increase customer dissatisfaction or otherwise harm our reputation.
If we fail to manage our exposure to global financial and securities market risks successfully, our operating results and financial statements could
be materially impacted.
The primary objective of our investment activities is to preserve principal. To achieve this objective, a majority of our marketable investments are
investment  grade,  liquid,  fixed-income  securities  and  money  market  instruments  denominated  in  U.S.  dollars.  If  the  carrying  value  of  an  investment
exceeds the fair value, and the decline in fair value is deemed to be other-than-temporary, we are required to write down the value of the investment, which
could  materially  harm  our  results  of  operations  and  financial  condition.  Moreover,  the  performance  of  certain  securities  in  our  investment  portfolio
correlates with the credit condition of the U.S. financial sector. In an unstable credit or economic environment, it is necessary to assess the value of our
investments more frequently and we might incur significant realized, unrealized or impairment losses associated with these investments.
Additionally, in July 2017, the United Kingdom Financial Conduct Authority announced that it would stop compelling banks to submit interest rates
for the calculation of the London Interbank Offered Rate (“LIBOR”) after 2021. Although we do not have any outstanding debt under our 2020 Credit
Facility, were we to draw on it, the outstanding amounts would bear interest at fluctuating interest rates on an approved replacement benchmark. We also
have other contracts indexed to LIBOR. We continue to monitor this matter and evaluate the related risks and potential impact of LIBOR’s expiration. Any
indebtedness that we incur may be indexed to a replacement benchmark, such as the Secured Overnight Financing Rate (“SOFR”). Any such change could
cause the effective interest rate under an agreement, including our 2020 Credit Facility, and our overall interest expense to increase, adversely affecting our
cash flows and results of operations.
If our goodwill or long-lived assets become impaired, we may be required to record a significant charge to earnings.
Under GAAP, we review our goodwill and long-lived asset group for impairment when events or changes in circumstances indicate the carrying value
may not be recoverable. Additionally, goodwill is required to be tested for impairment at least annually. The qualitative and quantitative analysis used to
test goodwill are dependent upon various assumptions and reflect management’s best estimates. Changes in certain assumptions including revenue growth
rates, discount rates, earnings multiples and future cash flows may cause a change in circumstances indicating that the carrying value of goodwill or the
asset group may be impaired and assessing these assumptions and predicting and forecasting future events can be difficult. Goodwill and purchased assets
require  periodic  fair  value  assessments  to  determine  if  they  have  become  impaired.  Consequently,  we  may  be  required  to  record  a  significant  charge  to
earnings in the financial statements during the period in which any impairment of goodwill or long-lived asset group is determined.
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Our effective tax rate may vary significantly from period to period.
Various  internal  and  external  factors  may  have  favorable  or  unfavorable  effects  on  our  future  effective  tax  rate.  These  factors  include,  but  are  not
limited to, changes in the global economic environment, changes in legal entity structure or activities performed within our entities, changes in tax laws,
regulations and/or rates, new or changes to accounting pronouncements, changing interpretations of existing tax laws or regulations, changes in the relative
proportions of revenues and income before taxes in the various jurisdictions in which we operate that have differing statutory tax rates, changes in overall
levels  of  pretax  earnings,  the  future  levels  of  tax  benefits  of  stock-based  compensation,  settlement  of  income  tax  audits  and  non-deductible  goodwill
impairments.  For  example,  our  effective  tax  rate  varied  significantly  in  the  first  quarter  of  fiscal  2020  due  to  the  relocation  of  our  EMEA  regional
headquarters from the Netherlands to Switzerland.
Our effective tax rate is also dependent in part on forecasts of full year results which can vary materially. Furthermore, we may continue to experience
significant variation in our effective tax rate related to excess tax benefits on stock-based compensation, particularly in the first quarter of each year when
the majority of our equity awards vest.
New  tax  laws  and  practice,  changes  to  existing  tax  laws  and  practice,  or  disputes  regarding  the  positions  we  take  regarding  tax  laws,  could
negatively affect our provision for income taxes as well as our ongoing operations.
As a U.S. multinational corporation, we are subject to tax laws both within and outside of the U.S. and significant judgment is required in determining
our  worldwide  provision  for  income  taxes.  Changes  in  tax  laws  or  changes  to  how  those  laws  are  applied  to  our  business  in  practice,  could  affect  the
amount of tax to which we are subject and the manner in which we operate. Additionally, the Organization for Economic Cooperation and Development’s
(“OECD”)  Base  Erosion  and  Profit  Shifting  (“BEPS”)  project  has  resulted  in  considerable  new  reporting  obligations  worldwide  as  OECD  member
countries have implemented its guidance. The OECD continues to publish guidance pursuant to the BEPS and other projects which, if adopted by member
countries, may affect our tax positions in many of the countries in which we do business.
Moreover, the application of indirect taxes (such as sales and use tax (“SUT”), value-added tax (“VAT”), goods and services tax (“GST”), and other
indirect taxes) to our operations is complex and evolving. U.S. states, local and foreign taxing jurisdictions have differing rules and regulations governing
differing types of taxes, and these rules and regulations are subject to varying interpretations and exemptions that may change over time. We collect and
remit SUT, VAT, GST and other taxes in many jurisdictions and we are routinely subject to audits. The positions we take regarding taxes as well as the
amounts we collect or remit may be challenged and we may be liable for failing to collect or remit all or any portion of taxes deemed owed or the taxes
could exceed our estimates. One or more U.S. states or countries may seek to impose incremental or new sales, use, or other tax collection obligations on us
or may determine that such taxes should have but have not been paid by us.
We are routinely subject to audits regarding our tax reporting and remissions by local and national governments. We may also be subject to audits in
U.S. states, local and foreign jurisdictions for which we have not accrued tax liabilities. The positions we take and assumptions we make regarding taxes as
well as the amounts we collect or remit may be challenged and we may be liable for failing to collect or remit all or any portion of taxes deemed owed or
the taxes could exceed our estimates. If we dispute rulings or positions taken by tax authorities, we may incur expenses and expend significant time and
effort to defend our positions, which may be costly.
The application of existing, new, or future tax laws, and results of audits, whether in the U.S. or internationally, could harm our business. Furthermore
there have been and will continue to be substantial ongoing costs associated with complying with the various tax requirements and defending our positions
in the numerous markets in which we conduct or will conduct business.
We  have  in  the  past  and  may  again  in  the  future  invest  in  or  acquire  other  businesses,  products  or  technologies  which  may  require  significant
management attention, disrupt our business, dilute stockholder value and adversely affect our results of operations.
Periodically, we may acquire, or make investments in, complementary companies, products or technologies like our acquisition of exocad in 2020.
Alternatively,  we  may  be  unable  to  find  suitable  investment  or  acquisition  targets  in  the  future,  and  we  may  not  be  able  to  complete  investments  or
acquisitions on favorable terms, if at all. If we do make investments or complete acquisitions, we may not ultimately strengthen our competitive position or
achieve  our  goals  or  desired  synergies,  and  any  investments  that  we  make  or  acquisitions  we  complete  could  be  viewed  negatively  by  our  customers,
securities analysts and investors. Moreover, to the extent we make strategic investments, the companies in which we invest may fail or we may ultimately
own less than a majority of the outstanding shares of the company and be outvoted on critical matters or issues that could harm us or the value of our
investment.
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Additionally, as an organization we do not have a history of significant acquisitions or integrating their operations and cultures with our own. As such
we are subject to multiple vulnerabilities and risks when making a strategic investment or acquisition, including we may:
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fail to perform proper due diligence and inherit or fail to uncover material issues of the acquired company or assets, including IP or other litigation
or ongoing investigations, accounting irregularities or improprieties, bribery, corruption or other compliance liabilities;
fail to comply with regulations, governmental orders or decrees;
create IT security and privacy compliance issues;
invest in companies that generate net losses and the market for their products, services or technologies may be slow to develop;
not  realize  a  positive  return  on  investment  or  determine  that  our  investments  have  declined  in  value,  such  that  we  may  be  required  to  record
impairments which could be material and could have an adverse impact on our financial results;
have to pay cash, incur debt or issue equity securities to pay for an acquisition, adversely affecting our liquidity, financial condition or the value of
our common stock. The sale of equity or issuance of debt to finance any acquisition could result in dilution to our stockholders. The occurrence of
indebtedness would result in increased fixed obligations and could also include covenants or other restrictions that would impede our ability to
manage our operations;
find  it  difficult  to  implement  and  harmonize  company-wide  financial  reporting,  forecasting  and  budgeting,  accounting,  billing,  information
technology and other systems due to inconsistencies in standards, internal controls, procedures and policies;
require significant time and resources to effectuate the transition;
fail to retain key personnel;
inaccurately forecast the financial impact of an acquired business;
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• not realize any or all or material portions of the expected synergies and benefits of the acquisition; or
• unsuccessfully evaluate or utilize the acquired technology or acquired company’s know-how or fail to successfully integrate any acquisitions or
the technologies acquired.
Moreover,  opposition  to  one  of  more  acquisitions  could  lead  to  negative  ratings  by  analysts  or  investors,  give  rise  to  objections  by  one  or  more
stockholders or result in stockholder activism, any of which could harm our stock price. Acquisitions can also lead to large non-cash charges that can have
an adverse effect on our results of operations as a result of write-offs for items such as future impairments of intangible assets and goodwill or the recording
of stock-based compensation.
Historically, the market price for our common stock has been volatile.
The market price of our common stock is subject to rapid and wide price fluctuations in response to various factors, many of which are beyond our
control. The factors include:
the impact on global and regional economies as a result of the COVID-19 pandemic;
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changes in recommendations by the investment community or speculation in the press or investment community regarding estimates of our net
revenues, operating results or other performance indicators;
announcements by us or our competitors or new market entrants, including strategic actions, management changes, and material transactions or
acquisitions;
technical factors in the public trading markets for our stock that may produce price movements that may or may not comport with macro, industry
or company-specific fundamentals, including, without limitation, the sentiment of retail investors (including as it may be expressed on financial
trading and other social media sites), the amount and status of short interest in our securities, access to margin debt, trading in options and other
derivatives on our common stock, fractional share trading, and other technical trading factors or strategies;
announcements regarding stock repurchases, sales of our common stock, credit agreements and debt issuances;
announcements  of  technological  innovations,  new,  additional  or  revised  programs,  business  models,  products  or  product  offerings  by  us,  our
customers or competitors;
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• key decisions in pending litigation, new litigation, settlements, judgments or decrees;
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• general economic market conditions.
sales of stock by us, our officers or directors; and
In addition, the stock market in general, and the market for technology and medical device companies, in particular, have experienced extreme price
and volume fluctuations that are often unrelated to or disproportionate to the operating performance of those companies. These broad market and industry
factors  may  include  market  expectations  of,  or  actual  changes  in,  monetary  policies  that  have  the  goal  of  easing  or  tightening  interest  rates  such  as  the
federal funds rate in the U.S. and austerity measures of governments intended to control budget deficits. Historically, our stock has fluctuated materially
based on broad
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economic  and  industry  factors  unrelated  to  our  actual  performance  and  future  changes  in  monetary  policies,  austerity,  and  other  market  factors  may
seriously harm the market price of our common stock, regardless of our operating performance. Historically, securities litigation, including securities class
action  lawsuits  and  securities  derivative  lawsuits,  is  often  brought  against  an  issuing  company  following  periods  of  volatility  in  the  market  price  of  its
securities and we have not been excepted from such litigation.
We cannot guarantee that we will continue to repurchase our common stock in the future, and any repurchases that we may make may not achieve
our desired objectives.
We have a history of recurring stock repurchase programs intended to return capital to our investors. Future stock repurchase programs are contingent
on a variety of factors, including our financial condition, results of operations, business requirements, and our Board of Directors' continuing determination
that stock repurchases are in the best interests of our stockholders and in compliance with all applicable laws and agreements. There is no assurance that we
will continue repurchasing our common stock in the future, consistent with historical levels or at all, or that our stock repurchase programs will have a
beneficial impact on our stock price.
Future sales of significant amounts of our common stock may depress our stock price.
A large percentage of our outstanding common stock is currently owned by a small number of significant stockholders. These stockholders have sold
in the past, and may sell in the future, large amounts of common stock over relatively short periods of time. Sales of substantial amounts of our common
stock in the public market by existing stockholders may adversely affect the market price of our common stock by creating the perception of difficulties or
problems with our business that may depress our stock price.
Increased scrutiny of our ESG policies and practices have and will likely continue to result in additional costs and risks, and may adversely impact
our reputation, employee retention, and willingness of customers and suppliers to do business with us.
Investor advocacy groups, institutional investors, investment funds, proxy advisory services, stockholders, and customers are increasingly focused on
ESG practices of companies. Additionally, public interest and legislative pressure related to public companies’ ESG practices continues to grow. If our ESG
practices  fail  to  meet  regulatory  requirements  or  investor  or  other  industry  stakeholders'  evolving  expectations  and  standards  for  responsible  corporate
citizenship  in  areas  including  environmental  stewardship,  support  for  local  communities,  board  of  director  and  employee  diversity,  human  capital
management, employee health and safety practices, product quality, supply chain management, corporate governance and transparency and employing ESG
strategies in our operations, our brand, reputation and employee retention may be negatively impacted and customers and suppliers may be unwilling to do
business with us. In addition, as we work to align our ESG practices with industry standards, we have expanded and, in the future, will likely continue to
expand our disclosures in these areas. We also expect to incur additional costs and require additional resources to monitor, report, and comply with our
various ESG practices. If we fail to adopt ESG standards or practices as quickly as stakeholders desire or regulators require, report on our ESG efforts or
practices accurately, or satisfy the disclosure and other expectations of stakeholders or regulators, our reputation, business, financial performance, growth,
and stock price may be adversely impacted.
Item 1B. Unresolved Staff Comments.
None.
38
Item 2. Properties.
We occupy several leased and owned facilities. As of December 31, 2021, the significant facilities occupied were as follows:
Location
Tempe, Arizona, U.S.A.
San Jose, California, U.S.A.
Raleigh, North Carolina, U.S.A.
San Jose, Costa Rica
Moscow, Russia
Petah Tikva, Israel
Rotkreuz, Switzerland
Juarez, Mexico
Ziyang, China
Lease/Own
Lease
Own
Own
Lease and Own
Lease
Lease and Own
Lease
Own
Own
Primary Use
Office for corporate headquarters
Office for research & development and administrative personnel
Office for Americas regional headquarters
Office for administrative personnel, treatment personnel, and customer care
Office for research & development
Manufacturing and office for research & development and administrative personnel
Office for EMEA regional headquarters
Manufacturing and office for administrative personnel
Manufacturing and office for administrative personnel
We  believe  our  existing  facilities  are  in  good  operating  condition  and  are  suitable  for  the  conduct  of  our  business.  The  significant  facilities  noted
above are used mostly by all our reportable segments. We also own property in Wroclaw, Poland where we expect to open a new aligner fabrication facility
that will begin serving doctors during the first half of 2022.
Item 3. Legal Proceedings.
For a discussion of legal proceedings, refer to Note 10 "Legal Proceedings" of the Notes to Consolidated Financial Statements in Part II, Item 8 of
this Form 10-K.
Item 4. Mine Safety Disclosures.
Not applicable.
39
Item 5. Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities.
Market Information
PART II
Our  common  stock  is  traded  on  the  NASDAQ  Global  Market  under  the  symbol  ALGN.  As  of  February  21,  2022,  there  were  approximately  53
holders of record of our common stock. Because the majority of our shares of outstanding common stock are held by brokers and other institutions on
behalf of stockholders, we are unable to estimate the total number of stockholders represented by these record holders.
Performance Graph
Notwithstanding any statement to the contrary in any of our previous or future filings with the SEC, the following information relating to the price
performance  of  our  common  stock  shall  not  be  deemed  “filed”  with  the  SEC  or  “Soliciting  Material”  under  the  Securities  Exchange  Act  of  1934,  as
amended, or subject to Regulation 14A or 14C, or to liabilities of Section 18 of the Exchange Act except to the extent we specifically request that such
information be treated as soliciting material or to the extent we specifically incorporate this information by reference.
The  graph  below  matches  our  cumulative  5-year  total  stockholder  return  on  common  stock  with  the  cumulative  total  returns  of  the  NASDAQ
Composite index, the S&P 500 index and the S&P 1500 Composite Health Care Equipment & Supplies index. The graph tracks the performance of a $100
investment in our common stock and each index (with the reinvestment of all dividends) from December 31, 2016 to December 31, 2021.
40
Unregistered Sales of Equity Securities
None.
Purchases of Equity Securities by the Issuer and Affiliated Purchasers
The following table summarizes the stock repurchase activity for the three months ended December 31, 2021:
Period
Total Number of
Shares Repurchased
Average Price
Paid per Share
Total Number of Shares
Repurchased as Part of
Publicly Announced
Programs
Approximate Dollar Value of
Shares that May Yet Be
Repurchased Under the
Programs
(1)
October 1, 2021 through October 31, 2021
November 1, 2021 through November 30, 2021
December 1, 2021 through December 31, 2021
Total
—  $
150,031  $
—  $
150,031 
— 
666.53 
— 
—  $
150,031  $
—  $
150,031 
824,962,500 
724,962,500 
724,962,500 
1 
May 2021 Repurchase Program. On May 13, 2021, we announced that our Board of Directors had authorized a plan to repurchase up to $1.0 billion of our
common  stock.  See  Note  13  “Common  Stock  Repurchase  Programs”  of  the  Notes  to  Consolidated  Financial  Statements  for  details  on  the  May  2021
Repurchase Program.
Item 6. [Reserved]
Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations.
The  following  discussion  and  analysis  of  our  financial  condition  and  results  of  operations  should  be  read  together  with  our  consolidated  financial
statements and related notes included elsewhere in this Annual Report on Form 10-K.
A  discussion  regarding  our  financial  condition  and  results  of  operations  for  fiscal  2021  compared  to  fiscal  2020  is  presented  under  Results  of
Operations of this Form 10-K. Discussions regarding our financial condition and results of operations for fiscal 2020 compared to 2019 have been omitted
from  this  Annual  Report  on  Form  10-K,  but  can  be  found  in  "Item  7.  Management's  Discussion  and  Analysis  of  Financial  Condition  and  Results  of
Operations" in our Annual Report on Form 10-K for the fiscal year ended December 31, 2020, filed with the SEC on February 26, 2021, which is available
without charge on the SEC's website at www.sec.gov and on our investor relations website at investor.aligntech.com.
Executive Overview of Results
Trends and Uncertainties
Our business strategic priorities remain focused on four principal pillars of growth: (i) international expansion; (ii) GP adoption; (iii) patient demand
and conversion; and (iv) orthodontic utilization.
We strive to deliver on each of our strategic growth drivers through a variety of interrelated enterprise-wide efforts including:
• Our growth depends on the continued penetration and adoption of Invisalign products, intraoral scanners and CAD/CAM solutions in international
markets.  We  continue  to  invest  in  manufacturing  operations,  research  and  development,  clinical  treatment  planning,  sales  and  marketing  and
building our quality and regulatory capabilities in existing and emerging markets globally. For instance, in 2021, we:
◦
◦
opened  new  offices  in  Israel  to  support  the  long-term  growth  of  iTero  scanner  and  services  business  for  treatment  planning  and  other
operations;
announced plans to open an aligner fabrication facility in Wroclaw, Poland as a part of our strategy to bring operational facilities closer to
customers and thereby serve them more quickly and respond to their needs more effectively as well as new treatment planning operations
in targeted regional geographies; and
41
◦
expanded our sales and marketing efforts into new countries and regions, including establishing offices in the African countries of Ghana
and Morocco.
• We  continue  to  see  growth  opportunities  with  international  orthodontists  and  GP  customers,  particularly  with  adopters  of  digital  dentistry
platforms  as  we  continue  to  tailor  our  sales  and  marketing  strategies  and  resources  around  the  unique  needs  of  each  customer  channel.  As  we
continue  growing,  we  intend  to  opportunistically  expand  our  research,  development,  manufacturing,  treatment  planning,  sales  and  marketing
operations to meet local and regional demand thoughtfully and deliberately. Over the longer-term, we expect international revenues to grow faster
than Americas' revenues as a result of growing international demand, our continued investment in international market expansion, the size of the
market opportunities and our relatively low market penetration of these regions.
• We  believe  our  training  and  education  efforts  are  important  to  building  the  confidence  within  the  GP  and  orthodontic  communities  needed  to
increase their adoption and utilization of clear aligner treatment. Accordingly, we continue to expand our Invisalign customer base by educating
new doctors on the benefits of digital dentistry through the Invisalign system and demonstrating to GPs and orthodontists how the iTero portfolio
of  intraoral  scanners  and  CAD/CAM  restorative  services  and  workflows  can  increase  the  profitability  of  their  dental  practices  by  enhancing
patient experiences.
However,  training  and  education  alone  are  insufficient  to  drive  adoption  and  utilization  growth  sufficiently.  We  need  to  continue  to  innovate,
develop and bring to market products and solutions that deliver the ever-increasing clinical precision and predictability doctors expect with the
speed  and  convenience  their  patients  require.  For  this  reason,  we  expect  to  continue  to  invest  in  research  and  development  and  open  facilities
closer to our customers and their patients to timely and conveniently support them.
•
Patient demand and conversion depends on making targeted investments in advertising and public relations through social media, influencers and
other  forms  of  digital  communications  to  encourage  patients  to  seek  treatment  from  Invisalign  trained  doctors.  We  believe  that  well-designed,
targeted sales and marketing promotions that build on our strong brand awareness and allow us to differentiate our products and solutions from
traditional  and  emerging  competitors.  Accordingly,  we  continue  to  increase  investments  intended  to  grow  consumer  demand.  For  instance,  in
2021, we introduced the “Invis-is” consumer advertising campaign with new creative content and influencers focused on teens, moms and young
adults.  We  expect  to  make  further  investments  to  create  additional  demand  for  Invisalign  system  treatment  driving  more  consumers  to  dental
professionals for those treatments.
In  addition,  we  are  pursuing  new  lines  of  Consumer  Products  that  are  complementary  to  our  doctor-prescribed  principal  products  currently
available in certain e-commerce channels in the U.S. Similarly, in order to grow our retainer business, which is significantly underpenetrated, we
have begun investing more directly in marketing strategies focused on driving adoption and increasing market share in the U.S.
• We expect global orthodontic utilization rates to continue increasing overall as doctors’ clinical confidence in the efficacy and predictability of the
Invisalign  system  increases  with  advancements  in  products  and  technology  and  as  patients  and  doctors  demand  treatments  that  emphasize
convenience and safety through fewer in office visits and less invasive and quicker treatments rise. In addition, the teenage and younger market
makes up 75% of the approximately 21 million total annual global orthodontic case starts each year. As we continue to emphasize the benefits of
the  Invisalign  system  for  teenage  and  younger  patient  treatments  through  education,  training  and  sales  and  marketing  programs,  we  expect
utilization rates to rise. However, our utilization rates will fluctuate from period to period due to a variety of factors, which may include seasonal
trends in our business, office closures or slowdowns related to COVID-19-related preventative measures and adoption rates for new products and
features. Refer to “COVID-19 Pandemic Update” below for further details.
•
To  achieve  these  strategic  pillars,  we  expect  to  continue  hiring  skilled  employees  in  our  clinical  engineering,  technology  development,
manufacturing,  sales  and  management  teams.  Expanding  our  workforce  will  require  that  we  offer  competitive  compensation  and  result  in
increasing costs which we expect to offset with increasing revenues.
COVID-19 Pandemic Update
The  COVID-19  pandemic  continues  to  cause  significant  volatility  and  uncertainty  in  the  global  and  regional  economies,  leading  to  changes  in
consumer and business behavior, fear and market fluctuations, materials and product shortages and restrictions on business and individual activities, all of
which is materially impacting supply and demand in broad sectors of the world markets. During 2021, many businesses and countries, including the U.S.,
continued  imposing  preventative  and  precautionary  measures  to  mitigate  the  spread  of  the  virus  and  its  variants.  As  a  result  of  the  restrictive  measures
imposed, the
42
demand for digital solutions has increased. Society and businesses continue to adapt to practices such as social distancing and remote working that further
the  need  for  greater  flexibility  and  convenience  of  digital  solutions.  Our  efforts  to  promote  the  digital  transformation  of  dental  practices  with  our  clear
aligners, intraoral scanners, clinical treatment planning and other offerings has allowed us to quickly respond to fluctuating demands in the dental field in
various regions.
Consequently, despite the economic challenges caused by the pandemic, our revenue grew by 59.9% in 2021 compared to 2020. The growth was a
combination  of  non-COVID  related  increases  as  well  as  lower  revenues  in  2020  as  the  initial  preventative  measures  to  combat  the  spread  of  the  virus
resulted in significant office closures and materially reduced operating capacities for many of our customers. Our overall business performance has been
strong, and we believe the digital transition to dentistry that began before the pandemic will continue to be positive for our business, results of operations,
cash flows, and financial condition, although we intend to adjust spending to coincide with the fluctuating pace of recovery and changes in demand. As
such, our recent operating results and levels of growth may not be indicative of our future performance.
The continuing evolution of the pandemic remains highly fluid and unpredictable, including the setbacks occurring as a result of new virus strains and
new or additional operating restrictions imposed on businesses, supply chain shortages and delays, the positive impacts of vaccinations, the uncertainties
regarding consumer spending as demand for entertainment, dining, and travel returns and remote working diminishes. Our top priority continues to be the
health  and  safety  of  our  employees  and  their  families,  our  customers  and  their  staff.  In  addition,  new  variants  of  the  virus  have  caused  unpredictable
fluctuations in the number of patients seeking treatment and the number of doctors providing the services and treatments. These fluctuations have adversely
impacted our results of operations from time to time in the recent past and are expected to continue to impact our results, particularly in the near term.
We continue to follow recommended safety measures, including encouraging employees to work from home when possible, suspending non-essential
work travel, and implementing various access controls at our facilities. In order to overcome the supply chain shortages and delays, we are also proactively
communicating with our suppliers and distributors and modifying our purchase order commitments to mitigate the risks of supply chain interruptions and
maintaining inventory levels greater than historically required.
Further discussion of the impact of the COVID-19 pandemic on our business may be found in Part I, Item 1A of this Annual Report on Form 10-K
under the heading “Risk Factors.”
Key financial and operating metrics
We  measure  our  performance  against  these  strategic  priorities  by  the  achievement  of  key  financial  and  operating  metrics.  For  the  year  ended
December 31, 2021, we achieved the following, taking into consideration that percentage changes from prior year financial results include the impact of
COVID-19 and do not necessarily reflect our future growth rates:
◦
◦
◦
Revenues of $3,952.6 million, an increase of 59.9% year-over-year;
Clear  Aligner  revenues  of  $3,247.1  million,  an  increase  of  54.5%  year-over-year  reflecting  the  expanding  opportunity  for  Invisalign
system treatment among adults globally, as well as the underlying orthodontic market as we continue to build awareness of the Invisalign
brand and drive utilization among teens and younger patients through increased consumer marketing.
▪ Americas Clear Aligner revenues of $1,544.8 million, an increase of 52.9% year-over-year;
▪
▪
International Clear Aligner revenues of $1,498.7 million, an increase of 55.2% year-over-year;
Clear Aligner volume increase of 54.8% year-over-year and Clear Aligner volume increase for teenage patients of 47.3% year-
over-year;
Imaging  Systems  and  CAD/CAM  Services  revenues  of  $705.5  million,  an  increase  of  90.4%  year-over-year  reflecting  strong  growth
across all regions with continued adoption of the iTero Element 5D and 5D Plus Series of next generation scanners and imaging systems
launched in February 2021, as well as increased average selling prices (“ASP”) predominately due to favorable product mix shift towards
higher priced scanners;
Income from operations of $976.4 million and operating margin of 24.7%;
Effective tax rate of 23.7%;
◦
◦
◦ Net income of $772.0 million with diluted net income per share of $9.69;
◦
◦ Operating cash flow of $1,172.5 million;
◦
◦ Number of employees was 22,540 as of December 31, 2021, an increase of 24.7% year-over-year.
Cash, cash equivalents and marketable securities of $1,296.7 million as of December 31, 2021;
Capital expenditures of $401.1 million, predominantly related to increases in our manufacturing capacity and facilities; and
43
Other Statistical Data and Trends
• Our  primary  goal  is  to  establish  clear  aligners  as  the  principal  solution  for  the  treatment  of  malocclusions  and  our  Invisalign  system  as  the
treatment  solution  of  choice  by  orthodontists,  GPs  and  patients  globally,  our  intraoral  scanning  platform  as  the  preferred  scanning  protocol  for
digital  dental  scans,  and  our  exocad  CAD/CAM  software  as  the  solution  of  choice  for  dental  labs.  As  of  December  31,  2021,  over  12  million
people  worldwide  have  been  treated  with  our  Invisalign  system,  over  68,000  iTero  scanners  have  been  sold  and  over  47,000  exocad  software
licenses  have  been  installed.  Management  measures  these  results  by  comparing  to  the  estimated  500  million  people  who  can  benefit  from
straighter teeth, 21 million annual orthodontic case starts and 2 million dental practices that could use intraoral scanners and uses this data to target
opportunities  to  expand  the  market  for  orthodontics  by  educating  consumers  about  the  benefits  of  straighter  teeth  using  the  Invisalign  system,
dental  professionals  and/or  labs  and  service  providers  to  use  iTero  intraoral  scanners,  and  dental  labs  and  practitioners  to  install  exocad
CAD/CAM software.
•
For the fourth quarter of 2021, total Invisalign cases submitted with a digital scanner in the Americas increased to 89.1%, up from 84.0% in the
fourth quarter of 2020 and international scans increased to 80.8%, up from 73.7% in the fourth quarter of 2020. For the fourth quarter of 2021,
96.4% of Invisalign cases submitted by North American orthodontists were submitted digitally. Our annual utilization rates for the last three fiscal
years are as follows:
* 
Invisalign utilization rates are calculated by the number of cases shipped divided by the number of doctors to whom cases were shipped. Our International region includes EMEA,
APAC. Latin America (“LATAM”) is excluded from the International region based on its immateriality to the year, however is included in the Total utilization.
• Total utilization rate in 2021 increased to 20.8 cases per doctor compared to 16.1 cases per doctor in 2020 and 15.9 cases per doctor in 2019.
• North America: Utilization rate among our North American orthodontist customers increased to 98.1 cases per doctor in 2021 compared
to  67.3  cases  per  doctor  in  2020  and  65.0  cases  per  doctor  in  2019  and  the  utilization  rate  among  our  North  American  GP  customers
increased to 14.3 cases per doctor in 2021 compared to 9.6 cases per doctor in 2020 and 9.5 cases per doctor in 2019.
•
International: International doctor utilization rate increased to 17.5 cases per doctor in 2021 compared to 14.5 cases per doctor in 2020
and 13.8 cases per doctor in 2019.
44
Results of Operations
Net Revenues by Reportable Segment
We group our operations into two reportable segments: Clear Aligner segment and Systems and Services segment.
• Our Clear Aligner segment consists of Comprehensive Products, Non-Comprehensive Products and Non-Case revenues as defined below:
• Comprehensive Products include, but are not limited to, Invisalign Comprehensive and Invisalign First.
• Non-Comprehensive  Products  include,  but  are  not  limited  to,  Invisalign  Moderate,  Lite  and  Express  packages  and  Invisalign  Go  and
Invisalign Go Plus.
• Non-Case  products  include,  but  are  not  limited  to,  retention  products,  Invisalign  training,  adjusting  tools  used  by  dental  professionals
during the course of treatment and, more recently, Consumer Products that are complementary to our doctor-prescribed principal products
such as aligner cases (clamshells), teeth whitening products, cleaning solutions (crystals, foam and other material) and other oral health
products available in certain e-commerce channels in the U.S.
• Our Systems and Services segment consists of our iTero intraoral scanning systems, which includes a single hardware platform and restorative or
orthodontic  software  options.  Our  services  include  subscription  software,  disposables,  rentals,  pay  per  scan  services,  as  well  as  exocad’s
CAD/CAM software solutions that integrate workflows to dental labs and dental practices.
Net  revenues  for  our  Clear  Aligner  and  Systems  and  Services  segments  by  region  for  the  year  ended  December  31,  2021,  2020  and  2019  are  as
follows (in millions):
Net Revenues
Clear Aligner revenues:
    Americas
    International
    Non-case
Total Clear Aligner net
revenues
Systems and Services net
revenues
Total net revenues
$
$
$
Year Ended December 31,
2021
2020
Change
Year Ended December 31,
2020
2019
Change
1,544.8  $
1,498.7 
203.7 
1,010.2  $
965.4 
125.8 
534.5 
533.2 
77.8 
52.9 % $
55.2 %
61.9 %
1,010.2  $
965.4 
125.8 
1,022.1  $
881.4 
122.3 
(11.9)
84.1 
3.5 
(1.2)%
9.5 %
2.9 %
3,247.1  $
2,101.5  $
1,145.6 
54.5 % $
2,101.5  $
2,025.8  $
75.7 
3.7 %
705.5 
3,952.6  $
370.5 
2,471.9  $
335.0 
1,480.6 
90.4 %
59.9 % $
370.5 
2,471.9  $
381.0 
2,406.8  $
(10.6)
65.1 
(2.8)%
2.7 %
Changes and percentages are based on actual values. Certain tables may not sum or recalculate due to rounding.
Clear Aligner Case Volume
Case volume data which represents Clear Aligner case shipments for the year ended December 31, 2021, 2020 and 2019 is as follows (in thousands):
Year Ended December 31,
2020
2021
Change
Year Ended December 31,
2019
2020
Change
Total case volume
2,547.7 
1,645.3 
902.4 
54.8 %
1,645.3 
1,537.1 
108.3 
7.0 %
Changes and percentages are based on actual values. Certain tables may not sum or recalculate due to rounding.
Total net revenues increased by $1,480.6 million in 2021 as compared to 2020 primarily as a result of increases in Clear Aligner volume of 54.8% and
an increase in the number of scanners recognized across most regions.
Clear Aligner - Americas
Americas  net  revenues  increased  by  $534.5  million  in  2021  as  compared  to  2020  primarily  due  to  a  57.6%  increase  in  volume  which  resulted  in
higher net revenues of $582.1 million, partially offset by lower ASP that decreased net revenues by
45
 
 
$47.7 million. Lower ASP was mostly due to higher promotional discounts which decreased revenue by $52.1 million and net deferrals which decreased
revenues by $40.3 million. The decreases in ASP were partially offset by favorable product mix shift which increased net revenues by $34.2 million and
favorable exchanges rates which increased net revenues by $12.2 million.
Clear Aligner - International
International net revenues increased by $533.2 million in 2021 as compared to 2020 primarily due to a 51.6% increase in volume which resulted in
higher net revenues by $497.8 million. Higher ASP increased net revenues by $35.4 million mostly due to favorable exchange rates which increased net
revenues by $61.8 million and favorable product mix shift which increased net revenues by $27.6 million. The increases in ASP were partially offset by
higher net deferrals which decreased net revenues by $49.6 million.
Clear Aligner - Non-Case
Non-case  net  revenues  increased  by  $77.8  million  in  2021  compared  to  2020  due  to  increased  volume  for  retention  products  across  all  regions
primarily driven by Vivera retainers.
Systems and Services
Systems and Services net revenues increased by $335.0 million in 2021 as compared to 2020 due to a higher number of scanners recognized which
increased net revenues by $186.3 million. Net revenues also increased by $97.7 million as a result of higher iTero service revenues mostly due to a larger
scanner install base and additional exocad CAD/CAM revenues. Additionally, higher scanner ASP increased net revenues by $51.0 million mostly due to
favorable product mix shift towards higher priced scanners such as the iTero Element Plus Series.
Cost of net revenues and gross profit (in millions):
Clear Aligner
Cost of net revenues
% of net segment revenues
Gross profit
Gross margin %
Systems and Services
Cost of net revenues
% of net segment revenues
Gross profit
Gross margin %
Total cost of net revenues
% of net revenues
Gross profit
Gross margin %
Year Ended December 31,
2020
2021
Change
Year Ended December 31,
2019
2020
Change
$
$
$
$
$
$
772.7 
23.8 %
2,474.4 
76.2 %
244.5 
34.7 %
461.0 
65.3 %
1,017.2 
25.7 %
2,935.4 
74.3 %
$
$
$
$
$
$
569.3 
27.1 %
1,532.1 
72.9 %
139.4 
37.6 %
231.1 
62.4 %
708.7 
28.7 %
1,763.2 
71.3 %
$
$
$
$
$
$
203.4  $
569.3 
27.1 %
942.2  $
1,532.1 
105.1  $
229.9  $
308.5  $
72.9 %
139.4 
37.6 %
231.1 
62.4 %
708.7 
28.7 %
1,172.1  $
1,763.2 
71.3 %
$
$
$
$
$
$
526.0 
26.0 %
1,499.7 
74.0 %
136.9 
35.9 %
244.2 
64.1 %
662.9 
27.5 %
1,743.9 
72.5 %
$
$
$
$
$
$
43.3 
32.4 
2.5 
(13.1)
45.8 
19.3 
Changes and percentages are based on actual values. Certain tables may not sum or recalculate due to rounding.
Cost of net revenues includes personnel-related costs including payroll and stock-based compensation for staff involved in the production process, the
cost of materials, packaging, freight and shipping related costs, depreciation on capital equipment and facilities used in the production process, amortization
of acquired intangible assets and training costs.
Clear Aligner
The  gross  margin  percentage  increased  in  2021  as  compared  to  2020  primarily  due  to  manufacturing  efficiencies  driven  by  higher  production
volumes.
46
 
 
Systems and Services
The gross margin percentage increased in 2021 as compared to 2020 as a result of higher ASP from a product mix shift and an increase in service
revenues which was partially offset by higher freight costs.
Selling, general and administrative (in millions):
Selling, general and administrative
% of net revenues
Year Ended December 31,
2020
2021
1,200.8 
1,708.6 
$
43.2 %
48.6 %
$
Change
$
507.9  $
Year Ended December 31,
2019
2020
1,072.1 
1,200.8 
$
48.6 %
44.5 %
Change
$
128.7 
Changes and percentages are based on actual values. Certain tables may not sum or recalculate due to rounding.
Selling, general and administrative expense generally includes personnel-related costs, including payroll, stock-based compensation and commissions
for our sales force, marketing and advertising expenses including media, public relations, marketing materials, clinical education, trade shows and industry
events,  legal  and  outside  service  costs,  equipment,  software  and  maintenance  costs,  depreciation  and  amortization  expense  and  allocations  of  corporate
overhead expenses including facilities and Information Technology (“IT”).
Selling, general and administrative expense increased in 2021 compared to 2020 primarily due to higher compensation related costs of $235.0 million
from higher salaries, fringe benefits, incentive bonuses and commissions due to increased headcount as we continue to invest in sales and marketing to
penetrate into new markets as well as higher advertising and marketing costs of $183.4 million.
Research and development (in millions):
Research and development
% of net revenues
$
250.3 
$
175.3 
$
75.0  $
175.3 
$
157.4 
$
17.9 
6.3 %
7.1 %
7.1 %
6.5 %
Year Ended December 31,
2020
2021
Change
Year Ended December 31,
2019
2020
Change
Changes and percentages are based on actual values. Certain tables may not sum or recalculate due to rounding.
Research and development expense generally includes personnel-related costs, including payroll and stock-based compensation, outside service costs
associated  with  the  research  and  development  of  new  products  and  enhancements  to  existing  products,  software,  equipment,  material  and  maintenance
costs, depreciation and amortization expense and allocations of corporate overhead expenses including facilities and IT.
Research and development expense increased in 2021 compared to 2020 primarily due to higher compensation costs including higher salaries, fringe
benefits and incentive bonuses mainly from increased headcount as we continue to focus our investments in innovation and research.
Income from operations (in millions):
Clear Aligner
Income from operations
Operating margin %
Systems and Services
Income from operations
Operating margin %
1
Total income from operations 
Operating margin %
Year Ended December 31,
2020
2021
Change
Year Ended December 31,
2019
2020
Change
$
$
$
1,325.9 
40.8 %
259.1 
36.7 %
976.4 
24.7 %
$
$
$
768.0 
36.5 %
96.1 
25.9 %
387.2 
15.7 %
$
$
$
557.8  $
163.1  $
589.2  $
768.0 
36.5 %
96.1 
25.9 %
387.2 
15.7 %
$
$
$
836.0 
41.3 %
137.7 
36.1 %
542.5 
22.5 %
$
$
$
(67.9)
(41.7)
(155.3)
Changes and percentages are based on actual values. Certain tables may not sum or recalculate due to rounding.
1
    Refer to Note 18 “Segments and Geographical Information” of the Notes to Consolidated Financial Statements for details on unallocated corporate expenses and
the reconciliation to Consolidated Income from Operations.
47
 
 
 
 
 
 
Clear Aligner
Operating margin percentage increased in 2021 compared to 2020 due to higher gross margins and operating leverage on higher net revenues.
Systems and Services
Operating margin percentage increased in 2021 compared to 2020 due to operating leverage on higher net revenues and higher gross margins due to a
favorable mix shift towards higher priced scanners.
Interest income (in millions):
Interest income
% of net revenues
Year Ended December 31,
2020
2021
$
$
3.1 
0.1 %
$
3.1 
0.1 %
Change
—  $
Year Ended December 31,
2019
2020
$
3.1 
0.1 %
12.5 
$
0.5 %
Change
(9.4)
Changes and percentages are based on actual values. Certain tables may not sum or recalculate due to rounding.
Interest income generally includes interest earned on cash, cash equivalents and investment balances. In 2021, there was no change to interest income
compared to 2020.
Other income (expense), net (in millions):
Other income (expense), net
% of net revenues
Year Ended December 31,
2020
2021
$
32.9 
$
0.8 %
(11.3)
(0.5)%
$
Change
44.3  $
Year Ended December 31,
2019
2020
(11.3)
(0.5)%
$
$
7.7 
0.3 %
Change
(19.0)
Changes and percentages are based on actual values. Certain tables may not sum or recalculate due to rounding.
Other income (expense), net, generally includes foreign exchange gains and losses, gains and losses on foreign currency forward contracts, interest
expense, gains and losses on equity investments and other miscellaneous charges.
Other  income  (expense),  net,  increased  in  2021  compared  to  2020  primarily  due  to  a  $43.4  million  gain  related  to  the  SDC  arbitration  award
recognized in the first quarter of 2021, a $10.2 million loss on a foreign currency forward contract related to the exocad acquisition recognized in 2020 and
an increase due to fair value changes relating to our investments in privately held companies recognized during 2021 compared to 2020. These increases
were partially offset by net foreign exchange losses in 2021 as compared to net foreign exchange gains in 2020.
Provision for (benefit from) income taxes (in millions):
Provision for (benefit from) income taxes
Effective tax rates
$
Year Ended December 31,
2020
2021
(1,396.9)
$
240.4 
23.7 %
Change
$
1,637.3  $
Year Ended December 31,
2020
2019
(1,396.9)
$
(368.6)%
(368.6)%
Change
$
(1,509.3)
112.3 
20.0 %
Changes and percentages are based on actual values. Certain tables may not sum or recalculate due to rounding.
The  increase  in  our  effective  tax  rate  for  the  year  ended  December  31,  2021  compared  to  2020  is  primarily  attributable  to  the  recognition  of  tax
benefits associated with the intra-entity transfer of certain intellectual property rights and fixed assets during the year ended December 31, 2020.
During  2020,  we  completed  an  intra-entity  transfer  of  certain  intellectual  property  rights  and  fixed  assets  to  our  Swiss  entity.  The  transfer  of
intellectual property rights did not result in a taxable gain; however, it did result in a step-up of the Swiss tax deductible basis in the transferred assets, and
accordingly,  created  a  temporary  difference  between  the  book  basis  and  the  tax  basis  of  such  intellectual  property  rights.  Consequently,  this  transaction
resulted in the recognition of a deferred tax asset and related one-time tax benefit of approximately $1,493.5 million during the year ended December 31,
2020, which is the net impact of the deferred tax asset recognized as a result of the additional Swiss tax deductible basis in the transferred assets and certain
costs related to the transfer of fixed assets and inventory. The amortization of this deferred tax asset depends on the
48
 
 
 
 
 
 
profitability of our Swiss headquarters and the recognition of this tax benefit is allowed for a maximum recovery period of 15 years.     
Liquidity and Capital Resources
Liquidity and Trends
As  of  December  31,  2021  and  2020,  we  had  the  following  cash  and  cash  equivalents  and  short-term  and  long-term  marketable  securities  (in
thousands):
Cash and cash equivalents
Marketable securities, short-term
Marketable securities, long-term
Total
December 31,
2021
2020
$
$
1,099,370  $
71,972 
125,320 
1,296,662  $
960,843 
— 
— 
960,843 
As  of  December  31,  2021  and  2020,  approximately  $713.8  million  and  $412.5  million,  respectively,  of  cash,  cash  equivalents  and  marketable
securities was held by our foreign subsidiaries. Our intent is to permanently reinvest our earnings from our international operations going forward, and our
current plans do not require us to repatriate them to fund our U.S. operations as we generate sufficient domestic operating cash flow and have access to
external funding under our $300.0 million revolving line of credit. We believe that our current cash balances and the borrowing capacity under our credit
facility, if necessary, will be sufficient to fund our business for at least the next 12 months.
Our material cash requirements as of December 31, 2021 are as below:
• Our  purchase  commitments  for  goods  and  services,  excluding  capital  expenditures,  totaled  $1,278.0  million,  of  which  $731.0  million  will  be
payable  within  the  next  12  months.  These  commitments  primarily  relate  to  agreements  with  contract  manufacturers  and  suppliers,  sales  and
marketing services, research and development services and technological services.
• We  expect  our  investments  in  capital  expenditures  to  exceed  $350.0  million  for  the  next  12  months.  Capital  expenditures  primarily  relate  to
building construction and improvements as well as additional manufacturing capacity to support our international expansion. This includes our
planned  investment  in  an  aligner  fabrication  facility  in  Wroclaw,  Poland,  which  is  expected  to  begin  serving  doctors  in  2022,  as  a  part  of  our
strategy  to  bring  operational  facilities  closer  to  customers.  As  we  continue  growing,  we  intend  to  expand  our  investments  in  research  and
development, manufacturing, treatment planning, sales and marketing operations to meet local and regional demand.
• We  have  future  operating  lease  payments  of  $160.8  million,  which  includes  $17.8  million  for  leases  that  have  not  yet  commenced  as  of
December 31, 2021. Refer to Note 4 “Leases” of the Notes to Consolidated Financial Statements for details on the lease payments.
• We  have  $725.0  million  available  for  repurchase  under  the  stock  repurchase  program  authorized  by  our  Board  of  Directors  in  May  2021.  Our
stock  repurchase  program  is  subject  to  periodic  evaluations  to  determine  when  and  if  repurchases  are  in  the  best  interests  of  our  stockholders,
taking into account prevailing market conditions. Refer to Note 13 “Common Stock Repurchase Programs” of the Notes to Consolidated Financial
Statements for  details  on  our  stock  repurchase  programs.  Subsequent  to  year  end,  during  February  2022,  we  repurchased  on  the  open  market
approximately 0.1 million shares of our common stock at an average price of $522.35 per share, including commissions, for an aggregate purchase
price of $75.0 million.
49
 
Sources and Use of Cash
The following table summarizes our Consolidated Statements of Cash Flows for the year ended December 31, 2021, 2020 and 2019 (in thousands):
2021
Year Ended December 31,
2020
2019
Net cash provided by (used in):
Operating activities
Investing activities
Financing activities
Effects of foreign exchange rate changes on cash, cash equivalents, and
restricted cash
$
Net increase (decrease) in cash, cash equivalents, and restricted cash $
1,172,544  $
(563,430)
(458,332)
(12,117)
138,665  $
662,174  $
(231,506)
(30,808)
10,480 
410,340  $
747,270 
(350,444)
(485,540)
2,282 
(86,432)
Operating Activities
For  the  year  ended  December  31,  2021,  cash  flows  from  operations  of  $1,172.5  million  resulted  primarily  from  our  net  income  of  approximately
$772.0 million as well as the following:
Significant adjustments to net income
• Stock-based compensation of $114.3 million related to equity awards granted to employees and directors;
• Depreciation and amortization of $108.7 million related to our investments in property, plant and equipment and intangible assets; and
• Gain related to our SDC arbitration award of $43.4 million.
Significant changes in working capital
•
•
•
•
Increase  of  $462.6  million  in  deferred  revenues  primarily  related  to  increased  case  volumes  in  our  Clear  Aligner  segment,  increased  scanner
volumes in our Systems and Services segment and timing of revenue recognition;
Increase of $262.1 million in accounts receivable which is primarily a result of the increase in sales;
Increase of $158.5 million in accrued and other long-term liabilities and an increase of $124.6 million in prepaid expenses and other assets due to
the timing of payment and activities; and
Increase of $112.5 million in inventories to support our demand, including safety stock, due to shipping delays during the COVID-19 pandemic as
well as long lead times with our suppliers.
For  the  year  ended  December  31,  2020,  cash  flows  from  operations  of  $662.2  million  resulted  primarily  from  our  net  income  of  approximately
$1,775.9 million as well as the following:
Significant adjustments to net income
• Deferred taxes of $1,491.6 million related to the one-time tax benefit associated with the intra-entity sale of certain intellectual property rights;
• Stock-based compensation of $98.4 million related to equity awards granted to employees and directors; and
• Depreciation and amortization of $93.5 million related to our investments in property, plant and equipment and intangible assets.
Significant changes in working capital
•
•
•
Increase of $228.1 million in deferred revenues primarily related to increased case volumes in our Clear Aligner segment and timing of revenue
recognition;
Increase of $139.8 million in accounts receivable which is primarily a result of the increase and timing in our sales; and
Increase of $52.2 million in accounts payable due to timing of certain invoice payments.
50
 
 
Investing Activities
Net cash used in investing activities was $563.4 million for the year ended December 31, 2021 and primarily consisted of purchases of property, plant
and equipment of $401.1 million and purchases of marketable securities of $200.9 million, which were partially offset by $43.4 million of proceeds from
our SDC arbitration award.
Net  cash  used  in  investing  activities  was  $231.5  million  for  the  year  ended  December  31,  2020,  which  primarily  consisted  of  cash  paid  for  the
acquisition  of  exocad  of  $420.8  million,  net  of  cash  acquired  and  purchases  of  property,  plant  and  equipment  of  $154.9  million.  These  outflows  were
partially offset by maturities and sales of marketable securities of $321.5 million and $26.9 million received from payments on an unsecured promissory
note issued by SDC in exchange for tendering our shares to them.
Financing Activities
Net cash used in financing activities was $458.3 million for the year ended December 31, 2021 which consisted of payments related to our accelerated
stock repurchase agreements of $375.0 million and payroll taxes paid for equity awards through share withholdings of $108.9 million which were partially
offset by $25.6 million of proceeds from the issuance of common stock.
Net  cash  used  in  financing  activities  was  $30.8  million  for  the  year  ended  December  31,  2020  consisted  of  payroll  taxes  paid  for  equity  awards
through share withholdings of $51.1 million which was partially offset by $20.3 million of proceeds from the issuance of common stock.
Critical Accounting Policies and Estimates
Management’s discussion and analysis of our financial condition and results of operations is based upon our consolidated financial statements, which
have been prepared in accordance with accounting principles generally accepted in the United States of America. The preparation of financial statements
requires management to make estimates and judgments that affect the reported amounts of assets and liabilities, revenues and expenses and disclosures at
the date of the financial statements. We evaluate our estimates on an on-going basis and use authoritative pronouncements, historical experience and other
assumptions as the basis for making the estimates. Actual results could differ from those estimates.
We believe the following critical accounting policies and estimates affect our more significant judgments used in the preparation of our consolidated
financial statements. For further information on all of our significant accounting policies, see Note 1 “Summary of Significant Accounting Policies” of the
Notes to Consolidated Financial Statements under Item 8.
Revenue Recognition
Our revenues are derived primarily from the sale of aligners, scanners, and services from our Clear Aligner and Systems and Services segments. We
enter into sales contracts that may consist of multiple distinct performance obligations where certain performance obligations of the sales contract are not
delivered in one reporting period. We measure and allocate revenues according to ASC 606-10, “Revenues from Contracts with Customers.”
Determining  the  standalone  selling  price  (“SSP”),  allocation  of  consideration  from  the  contract  to  the  individual  performance  obligations  and  the
appropriate timing of revenue recognition is the result of significant qualitative and quantitative judgments. While changes in the allocation of the SSP
between performance obligations will not affect the amount of total revenues recognized for a particular contract, any material changes could impact the
timing  of  revenue  recognition,  which  would  have  a  material  effect  on  our  financial  position  and  result  of  operations.  This  is  because  the  contract
consideration  is  allocated  to  each  performance  obligation,  delivered  or  undelivered,  at  the  inception  of  the  contract  based  on  the  SSP  of  each  distinct
performance obligation.
We  allocate  revenues  for  each  clear  aligner  treatment  plan  based  on  each  unit’s  SSP.  Management  considers  a  variety  of  factors  such  as  same  or
similar  product  historical  sales,  costs,  and  gross  margin,  which  may  vary  over  time  depending  upon  the  unique  facts  and  circumstances  related  to  each
performance obligation in making these estimates. For treatment plans with multiple future performance obligations, we also consider usage rates, which is
the number of times a customer is expected to order more aligners after the initial shipment. Our process for estimating usage rates requires significant
judgment and evaluation of inputs, including historical usage data by region, country and channel.
We estimate the SSP of each element in a scanner system and services sale taking into consideration same or similar product historical prices as well
as our discounting strategies.
51
Unfulfilled Performance Obligations for Clear Aligners and Scanners
The estimated revenues expected to be recognized in the future related to our unfulfilled performance obligations, including deferred revenues and
backlog, as of December 31, 2021 is $1,307.3 million. This estimate includes both product and service unfulfilled performance obligations and the time
range reflects our best estimate of when we will transfer control to the customer and may change based on customer usage patterns, timing of shipments,
readiness of customers' facilities for installation, and manufacturing availability all of which involve significant judgement. Generally, our deferred revenue
will be recognized over a period of one to five years.
Goodwill and Finite-Lived Acquired Intangible Assets
Goodwill  and  acquired  intangible  assets  with  finite  lives  are  subject  to  impairment  testing  and  are  reviewed  for  impairment  when  events  or
circumstances indicate that the carrying value of an asset is not recoverable and the carrying amount exceeds its fair value. We evaluate the recoverability
of the carrying value of these identifiable intangible assets based on estimated undiscounted cash flows to be generated from such assets. If the cash flow
estimates or the significant operating assumptions upon which they are based change in the future, we may be required to record impairment charges.
Assumptions and estimates about future values and remaining useful lives of our acquired intangible assets are complex and subjective. They can be
affected by external factors such as industry and economic trends and internal factors such as changes in our business strategy and internal forecasts. Our
ongoing consideration of all these factors could result in impairment charges in the future.
If we were to have impairments to goodwill or finite-lived acquired intangible assets, it could adversely affect our operating results. During the fiscal
year 2021 and 2020, we did not have any impairment charges related to our goodwill or acquired intangible assets.
Accounting for Income Taxes
We  are  subject  to  income  taxes  in  the  U.S.  and  numerous  foreign  jurisdictions.  The  evaluation  of  our  uncertain  tax  positions  involves  significant
judgment  in  the  interpretation  and  application  of  U.S.  GAAP  and  complex  domestic  and  international  tax  laws  related  to  the  allocation  of  international
taxation rights between countries. We are also required to evaluate the realizability of our deferred tax assets on an ongoing basis in accordance with U.S.
GAAP, which requires the assessment of both of our historical and future performance as well as other relevant factors. Realization of our deferred tax
assets is dependent on our ability to generate future taxable income which is determined based on assumptions such as estimated growth rates in revenues,
gross  margins,  future  cash  flows  and  discount  rates.  The  accuracy  of  these  estimates  could  be  affected  by  unforeseen  events  or  actual  results,  and  the
sustainability of our future tax benefits is dependent upon the acceptance of these valuation estimates and assumptions by the taxing authorities.
Accounting for Legal Proceedings and Litigation
Estimates of probable losses resulting from litigation are inherently difficult to make, particularly when the matters are in early procedural stages with
incomplete facts and information. The final outcome of legal proceedings is dependent on many variables difficult to predict and, therefore, the ultimate
cost  to  entirely  resolve  such  matters  may  be  materially  different  than  the  amount  of  current  estimates.  Consequently,  new  information  or  changes  in
judgments and estimates could have a material adverse effect on our business, financial condition, and results of operations or cash flows.
Recent Accounting Pronouncements
See Note 1 “Summary  of  Significant  Accounting  Policies”  of  the  Notes  to  Consolidated  Financial  Statements  in  Item 8  for  a  discussion  of  recent
accounting  pronouncements,  including  the  expected  dates  of  adoption  and  estimated  effects  on  results  of  operations  and  financial  condition,  which  is
incorporated herein.
Item 7A. Quantitative and Qualitative Disclosures About Market Risk.
In the normal course of business, we are exposed to foreign currency exchange rate and interest rate risks that could impact our financial position and
results of operations. In addition, we are subject to the broad market risk that is created by the global market disruptions and uncertainties resulting from
the COVID-19 pandemic. Further discussion of the impact of the COVID-19 pandemic on our business may be found in Item 1A of this Annual Report on
Form 10-K under the heading “Risk Factors”.
52
Interest Rate Risk
Changes  in  interest  rates  could  impact  our  anticipated  interest  income  on  our  cash  equivalents  and  investments  in  marketable  securities.  Our
investments are fixed-rate short-term and long-term securities. Fixed-rate securities may have their fair market value adversely impacted due to a rise in
interest  rates,  and,  as  a  result,  our  future  investment  income  may  fall  short  of  expectations  due  to  changes  in  interest  rates  or  we  may  suffer  losses  in
principal if forced to sell securities which have declined in market value due to changes in interest rates. As of December 31, 2021, we had approximately
$197.3 million invested in available-for-sale marketable securities. An immediate 10% change in interest rates would not have a material adverse impact on
our future operating results and cash flows.
We do not enter into investments for trading or speculative purposes and have not used any derivative financial instruments to manage our interest
rate risk exposure. Based on interest bearing liabilities we have as of December 31, 2021, we are not subject to risks from immediate interest rate increases.
Currency Rate Risk
As a result of our international business activities, our financial results could be affected by factors such as changes in foreign currency exchange
rates  or  economic  conditions  in  foreign  markets,  and  there  is  no  assurance  that  exchange  rate  fluctuations  will  not  harm  our  business  in  the  future. We
generally sell our products in the local currency of the respective countries. This provides some natural hedging because most of the subsidiaries’ operating
expenses are generally denominated in their local currencies. Regardless of this natural hedging, our results of operations may be adversely impacted by
exchange rate fluctuations.
We primarily enter into foreign currency forward contracts to minimize the short-term impact of foreign currency exchange rate fluctuations on cash
and certain trade and intercompany receivables and payables. These forward contracts are not designated as hedging instruments and do not subject us to
material balance sheet risk due to fluctuations in foreign currency exchange rates. The gains and losses on these forward contracts are intended to offset the
gains and losses in the underlying foreign currency denominated monetary assets and liabilities being economically hedged. These instruments are marked
to  market  through  earnings  every  period  and  generally  are  one  month  in  original  maturity.  We  do  not  enter  into  foreign  currency  forward  contracts  for
trading  or  speculative  purposes.  As  our  international  operations  grow,  we  will  continue  to  reassess  our  approach  to  managing  the  risks  relating  to
fluctuations in currency rates. It is difficult to predict the impact forward contracts could have on our results of operations.
Although we will continue to monitor our exposure to currency fluctuations, and, where appropriate, may use forward contracts to minimize the effect
of these fluctuations, the impact of an aggregate change of 10% in foreign currency exchange rates relative to the U.S. dollar on our results of operations
and financial position could be material.
53
Item 8. Financial Statements and Supplementary Data.
INDEX TO CONSOLIDATED FINANCIAL STATEMENTS
Report of Management on Internal Control over Financial Reporting
Report of Independent Registered Public Accounting Firm (PCAOB ID 238)
Consolidated Statements of Operations for the year ended December 31, 2021, 2020 and 2019
Consolidated Statements of Comprehensive Income for the year ended December 31, 2021, 2020 and 2019
Consolidated Balance Sheets as of December 31, 2021 and 2020
Consolidated Statements of Stockholders’ Equity for the year ended December 31, 2021, 2020 and 2019
Consolidated Statements of Cash Flows for the year ended December 31, 2021, 2020 and 2019
Notes to Consolidated Financial Statements
54
Page
55
56
58
59
60
61
62
63
 
 
REPORT OF MANAGEMENT ON INTERNAL CONTROL OVER FINANCIAL REPORTING
Management of Align is responsible for establishing and maintaining adequate internal control over financial reporting as defined in Rules 13a-15(f)
and 15d-15(f) under the Securities Exchange Act of 1934. Our internal control over financial reporting is designed by, or under supervision of, our CEO
and CFO, and effected by the board of directors, management and other personnel to provide reasonable assurance regarding the reliability of financial
reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles. Internal control
over financial reporting includes those policies and procedures that:
•
•
•
pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets of Align;
provide reasonable assurance that transactions are recorded as necessary to permit preparation of financial statements in accordance with generally
accepted accounting principles, and that receipts and expenditures of Align are being made only in accordance with authorizations of management
and directors of Align; and
provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use or disposition of Align’s assets that could
have a material effect on the financial statements.
Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. In addition, projections of any
evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions or that the degree
of compliance with the policies or procedures may deteriorate.
Management  assessed  the  effectiveness  of  our  internal  control  over  financial  reporting  as  of  December  31,  2021.  In  making  this  assessment,
management  used  the  criteria  set  forth  in  Internal  Control-Integrated  Framework (2013) issued  by  the  Committee  of  Sponsoring  Organizations  of  the
Treadway Commission ("COSO").
Based on our assessment, management has concluded that, as of December 31, 2021, our internal control over financial reporting was effective based
on criteria in Internal Control - Integrated Framework (2013) issued by the COSO.
The  effectiveness  of  our  internal  control  over  financial  reporting  as  of  December  31,  2021  has  been  audited  by  PricewaterhouseCoopers  LLP,  an
independent registered public accounting firm, as stated in their report which is included herein.
/S/    JOSEPH M. HOGAN        
Joseph M. Hogan
President and Chief Executive Officer
February 25, 2022
/S/    JOHN F. MORICI 
John F. Morici
Chief Financial Officer and Executive Vice President, Global Finance
February 25, 2022
55
 
Report of Independent Registered Public Accounting Firm
To the Board of Directors and Stockholders of Align Technology, Inc.
Opinions on the Financial Statements and Internal Control over Financial Reporting
We have audited the accompanying consolidated balance sheets of Align Technology, Inc. and its subsidiaries (the “Company”) as of December 31,
2021 and 2020, and the related consolidated statements of operations, comprehensive income, stockholders’ equity and cash flows for each of the three
years in the period ended December 31, 2021, including the related notes and financial statement schedule listed in the index appearing under Item 15(a)(2)
(collectively  referred  to  as  the  “consolidated  financial  statements”). We  also  have  audited  the  Company's  internal  control  over  financial  reporting  as  of
December 31, 2021, based on criteria established in Internal Control - Integrated Framework (2013) issued by the Committee of Sponsoring Organizations
of the Treadway Commission (COSO).
In our opinion, the consolidated financial statements referred to above present fairly, in all material respects, the financial position of the Company as
of December 31, 2021 and 2020, and the results of its operations and its cash flows for each of the three years in the period ended December 31, 2021 in
conformity with accounting principles generally accepted in the United States of America. Also in our opinion, the Company maintained, in all material
respects,  effective  internal  control  over  financial  reporting  as  of  December  31,  2021,  based  on  criteria  established  in  Internal  Control  -  Integrated
Framework (2013) issued by the COSO.
Basis for Opinions
The  Company's  management  is  responsible  for  these  consolidated  financial  statements,  for  maintaining  effective  internal  control  over  financial
reporting, and for its assessment of the effectiveness of internal control over financial reporting, included in the accompanying Report of Management on
Internal  Control  over  Financial  Reporting.  Our  responsibility  is  to  express  opinions  on  the  Company’s  consolidated  financial  statements  and  on  the
Company's internal control over financial reporting based on our audits. We are a public accounting firm registered with the Public Company Accounting
Oversight Board (United States) (PCAOB) and are required to be independent with respect to the Company in accordance with the U.S. federal securities
laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB.
We  conducted  our  audits  in  accordance  with  the  standards  of  the  PCAOB.  Those  standards  require  that  we  plan  and  perform  the  audits  to  obtain
reasonable  assurance  about  whether  the  consolidated financial  statements  are  free  of  material  misstatement,  whether  due  to  error  or  fraud,  and  whether
effective internal control over financial reporting was maintained in all material respects.
Our audits of the consolidated financial statements included performing procedures to assess the risks of material misstatement of the consolidated
financial statements, whether due to error or fraud, and performing procedures that respond to those risks. Such procedures included examining, on a test
basis,  evidence  regarding  the  amounts  and  disclosures  in  the  consolidated  financial  statements.  Our  audits  also  included  evaluating  the  accounting
principles used and significant estimates made by management, as well as evaluating the overall presentation of the consolidated financial statements. Our
audit of internal control over financial reporting included obtaining an understanding of internal control over financial reporting, assessing the risk that a
material weakness exists, and testing and evaluating the design and operating effectiveness of internal control based on the assessed risk. Our audits also
included performing such other procedures as we considered necessary in the circumstances. We believe that our audits provide a reasonable basis for our
opinions.
Definition and Limitations of Internal Control over Financial Reporting
A  company’s  internal  control  over  financial  reporting  is  a  process  designed  to  provide  reasonable  assurance  regarding  the  reliability  of  financial
reporting  and  the  preparation  of  financial  statements  for  external  purposes  in  accordance  with  generally  accepted  accounting  principles.  A  company’s
internal  control  over  financial  reporting  includes  those  policies  and  procedures  that  (i)  pertain  to  the  maintenance  of  records  that,  in  reasonable  detail,
accurately and fairly reflect the transactions and dispositions of the assets of the company; (ii) provide reasonable assurance that transactions are recorded
as necessary to permit preparation of financial statements in accordance with generally accepted accounting principles, and that receipts and expenditures
of the company are being made only in accordance with authorizations of management and directors of the company; and (iii) provide reasonable assurance
regarding prevention or timely detection of unauthorized acquisition, use, or disposition of the company’s assets that could have a material effect on the
financial statements.
Because  of  its  inherent  limitations,  internal  control  over  financial  reporting  may  not  prevent  or  detect  misstatements.  Also,  projections  of  any
evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate
56
because of changes in conditions, or that the degree of compliance with the policies or procedures may deteriorate.
Critical Audit Matters
The  critical  audit  matter  communicated  below  is  a  matter  arising  from  the  current  period  audit  of  the  consolidated  financial  statements  that  was
communicated or required to be communicated to the audit committee and that (i) relates to accounts or disclosures that are material to the consolidated
financial statements and (ii) involved our especially challenging, subjective, or complex judgments. The communication of critical audit matters does not
alter in any way our opinion on the consolidated financial statements, taken as a whole, and we are not, by communicating the critical audit matter below,
providing a separate opinion on the critical audit matter or on the accounts or disclosures to which it relates.
Revenue Recognition – Determination of Standalone Selling Price of Distinct Performance Obligations in Clear Aligner Contracts
As described in Notes 1 and 18 to the consolidated financial statements, the Company recognized net revenues of $3.2 billion from its Clear Aligner
segment  for  the  year  ended  December  31,  2021.  The  Company  enters  into  contracts  (“treatment  plans”)  that  involve  multiple  future  performance
obligations. Management identifies a performance obligation as distinct if both of the following criteria are met: the customer can benefit from the good or
service either on its own or together with other resources that are readily available to the customer, and the entity’s promise to transfer the good or service
to the customer is separately identifiable from other promises in the contract. Determining the standalone selling price, allocation of consideration from the
contract to the individual performance obligations, and the appropriate timing of revenue recognition is the result of significant qualitative and quantitative
judgments. Management considers a variety of factors such as same or similar product historical sales, costs, and gross margin, which may vary over time
depending upon the unique facts and circumstances related to each performance obligation in making these estimates. Management also considers usage
rates,  which  is  the  number  of  times  a  customer  is  expected  to  order  additional  aligners.  Management’s  process  for  estimating  usage  rates  requires
significant judgment and evaluation of inputs, including historical usage data by region, country and channel.
The  principal  considerations  for  our  determination  that  performing  procedures  related  to  revenue  recognition  and  the  determination  of  standalone
selling  price  of  distinct  performance  obligations  in  Clear  Aligner  contracts  is  a  critical  audit  matter  are  the  significant  judgment  by  management  in
determining the estimate of standalone selling price, which includes significant assumptions related to usage rates for each distinct performance obligation.
This in turn led to significant auditor judgment, subjectivity, and effort in performing procedures to evaluate management’s determination of the estimates
of standalone selling price and usage rates for each distinct performance obligation.
Addressing  the  matter  involved  performing  procedures  and  evaluating  audit  evidence  in  connection  with  forming  our  overall  opinion  on  the
consolidated financial statements. These procedures included testing the effectiveness of controls relating to revenue recognition, including controls over
the  determination  of  standalone  selling  price  for  each  distinct  performance  obligation  in  the  Company’s  Clear  Aligner  contracts.  These  procedures  also
included, among others, (i) testing management’s process for determining the estimate of standalone selling price, which included testing the completeness
and accuracy of inputs used and evaluating the reasonableness of factors considered by management related to same or similar product historical sales and
usage  rates,  and  (ii)  testing  management’s  process  for  estimating  usage  rates,  which  included  evaluating  the  reasonableness  of  inputs  evaluated  by
management related to historical usage data by region, country and channel.
/s/ PricewaterhouseCoopers LLP
San Jose, California
February 25, 2022
We have served as the Company’s auditor since 1997.
57
ALIGN TECHNOLOGY, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF OPERATIONS
(in thousands, except per share data)
Net revenues
Cost of net revenues
Gross profit
Operating expenses:
Selling, general and administrative
Research and development
Impairments and other charges (gains), net
Litigation settlement gain
Total operating expenses
Income from operations
Interest income and other income (expense), net:
Interest income
Other income (expense), net
Total interest income and other income (expense), net
Net income before provision for (benefit from) income taxes and
equity in losses of investee
Provision for (benefit from) income taxes
Equity in losses of investee, net of tax
Net income
Net income per share:
Basic
Diluted
Shares used in computing net income per share:
Basic
Diluted
$
$
$
$
2021
Year Ended December 31,
2020
2019
3,952,584  $
1,017,229 
2,935,355 
2,471,941  $
708,706 
1,763,235 
1,708,640 
250,315 
— 
— 
1,958,955 
976,400 
3,103 
32,920 
36,023 
1,012,423 
240,403 
— 
772,020  $
9.78  $
9.69  $
78,917 
79,670 
1,200,757 
175,307 
— 
— 
1,376,064 
387,171 
3,125 
(11,347)
(8,222)
378,949 
(1,396,939)
— 
1,775,888  $
22.55  $
22.41  $
78,760 
79,230 
2,406,796 
662,899 
1,743,897 
1,072,053 
157,361 
22,990 
(51,000)
1,201,404 
542,493 
12,482 
7,676 
20,158 
562,651 
112,347 
7,528 
442,776 
5.57 
5.53 
79,424 
80,100 
The accompanying notes are an integral part of these consolidated financial statements.
58
 
 
 
ALIGN TECHNOLOGY, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME
(in thousands)
Net income
Other comprehensive income (loss):
Change in foreign currency translation adjustment, net of tax
Change in unrealized gains (losses) on investments, net of tax
Other comprehensive income (loss)
Comprehensive income
2021
Year Ended December 31,
2020
2019
772,020  $
1,775,888  $
442,776 
(38,680)
(495)
(39,175)
732,845  $
44,383 
(194)
44,189 
1,820,077  $
1,787 
299 
2,086 
444,862 
$
$
The accompanying notes are an integral part of these consolidated financial statements.
59
 
 
ALIGN TECHNOLOGY, INC. AND SUBSIDIARIES
CONSOLIDATED BALANCE SHEETS
(in thousands, except per share data)
December 31,
2021
2020
ASSETS
Current assets:
Cash and cash equivalents
Marketable securities, short-term
Accounts receivable, net of allowance for doubtful accounts of $9,245 and $10,239, respectively
Inventories
Prepaid expenses and other current assets
Total current assets
Marketable securities, long-term
Property, plant and equipment, net
Operating lease right-of-use assets, net
Goodwill
Intangible assets, net
Deferred tax assets
Other assets
Total assets
LIABILITIES AND STOCKHOLDERS’ EQUITY
Current liabilities:
Accounts payable
Accrued liabilities
Deferred revenues
Total current liabilities
Income tax payable
Operating lease liabilities
Other long-term liabilities
Total liabilities
Commitments and contingencies (Notes 10 and 11)
Stockholders’ equity:
Preferred stock, $0.0001 par value (5,000 shares authorized; none issued)
Common stock, $0.0001 par value (200,000 shares authorized; 78,710 and 78,860 issued and
outstanding, respectively)
Additional paid-in capital
Accumulated other comprehensive income (loss), net
Retained earnings
Total stockholders’ equity
Total liabilities and stockholders’ equity
$
$
$
$
1,099,370  $
71,972 
897,198 
230,230 
195,305 
2,494,075 
125,320 
1,081,926 
121,257 
418,547 
109,709 
1,533,767 
57,509 
5,942,110  $
163,886  $
607,315 
1,152,870 
1,924,071 
118,072 
102,656 
174,597 
2,319,396 
— 
8 
999,006 
4,326 
2,619,374 
3,622,714 
5,942,110  $
960,843 
— 
657,704 
139,237 
91,754 
1,849,538 
— 
734,721 
82,553 
444,817 
130,072 
1,552,831 
35,151 
4,829,683 
142,132 
405,582 
777,887 
1,325,601 
105,748 
64,445 
100,024 
1,595,818 
— 
8 
974,556 
43,501 
2,215,800 
3,233,865 
4,829,683 
The accompanying notes are an integral part of these consolidated financial statements.
60
ALIGN TECHNOLOGY, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY
(in thousands)
Balance as of December 31, 2018
Net income
Net change in unrealized gains (losses) from investments
Net change in foreign currency translation adjustment
Issuance of common stock relating to employee equity
compensation plans
Tax withholdings related to net share settlements of
equity awards
Common stock repurchased and retired
Stock-based compensation
Balance as of December 31, 2019
Net income
Net change in unrealized gains (losses) from investments
Net change in foreign currency translation adjustment
Issuance of common stock relating to employee equity
compensation plans
Tax withholdings related to net share settlements of
equity awards
Stock-based compensation
Balance as of December 31, 2020
Net income
Net change in unrealized gains (losses) from investments
Net change in foreign currency translation adjustment
Issuance of common stock relating to employee equity
compensation plans
Tax withholdings related to net share settlements of
equity awards
Common stock repurchased and retired
Stock-based compensation
Balance as of December 31, 2021
Common Stock
Shares
79,778  $
— 
— 
— 
542 
— 
(1,887)
— 
78,433 
— 
— 
— 
427 
— 
— 
78,860 
— 
— 
— 
442 
— 
(592)
— 
78,710  $
Amount
8  $
— 
— 
— 
— 
— 
— 
— 
8 
— 
— 
— 
— 
— 
— 
8 
— 
— 
— 
— 
— 
— 
— 
8  $
Additional
Paid-In
Capital
877,514  $
— 
— 
— 
Accumulated
Other
Comprehensive
Income (Loss), Net
Retained
Earnings
(2,774) $
— 
299 
1,787 
378,143  $
442,776 
— 
— 
Total
1,252,891 
442,776 
299 
1,787 
17,907 
(57,676)
(18,992)
88,184 
906,937 
— 
— 
— 
20,314 
(51,122)
98,427 
974,556 
— 
— 
— 
25,623 
— 
— 
— 
— 
(688)
— 
(194)
44,383 
— 
— 
— 
43,501 
— 
(495)
(38,680)
— 
17,907 
— 
(381,007)
— 
439,912 
1,775,888 
— 
— 
(57,676)
(399,999)
88,184 
1,346,169 
1,775,888 
(194)
44,383 
— 
20,314 
— 
— 
2,215,800 
772,020 
— 
— 
(51,122)
98,427 
3,233,865 
772,020 
(495)
(38,680)
— 
— 
25,623 
(108,917)
(6,592)
114,336 
999,006  $
— 
— 
— 
4,326  $
— 
(368,446)
— 
2,619,374  $
(108,917)
(375,038)
114,336 
3,622,714 
The accompanying notes are an integral part of these consolidated financial statements.
61
ALIGN TECHNOLOGY, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF CASH FLOWS
(in thousands)
CASH FLOWS FROM OPERATING ACTIVITIES:
Net income
Adjustments to reconcile net income to net cash provided by operating activities:
Deferred taxes
Depreciation and amortization
Stock-based compensation
Non-cash operating lease cost
Allowance for doubtful accounts provisions
Arbitration award gain
Impairments on long-lived assets
Equity in losses of investee
Gain on lease terminations
Gain from sale of equity method investment
Other non-cash operating activities
Changes in assets and liabilities, net of effects of acquisition:
Accounts receivable
Inventories
Prepaid expenses and other assets
Accounts payable
Accrued and other long-term liabilities
Long-term income tax payable
Deferred revenues
                   Net cash provided by operating activities
CASH FLOWS FROM INVESTING ACTIVITIES:
Acquisition, net of cash acquired
Purchase of property, plant and equipment
Purchase of marketable securities
Proceeds from maturities of marketable securities
Proceeds from sales of marketable securities
Repayment on unsecured promissory note
Proceeds from arbitration award
Other investing activities
                   Net cash used in investing activities
CASH FLOWS FROM FINANCING ACTIVITIES:
Proceeds from issuance of common stock
Common stock repurchases
Payroll taxes paid upon the vesting of equity awards
Purchase of finance lease
                    Net cash used in financing activities
Effect of foreign exchange rate changes on cash, cash equivalents, and restricted cash
            Net increase (decrease) in cash, cash equivalents, and restricted cash
                    Cash, cash equivalents, and restricted cash at beginning of year
                    Cash, cash equivalents, and restricted cash at end of year
Year Ended December 31,
2020
2019
2021
$
772,020  $
1,775,888  $
442,776 
15,455 
108,729 
114,336 
26,807 
2,814 
(43,403)
— 
— 
— 
— 
21,549 
(262,066)
(112,450)
(124,626)
19,747 
158,543 
12,449 
462,640 
1,172,544 
(8,002)
(401,098)
(200,928)
498 
3,114 
4,594 
43,403 
(5,011)
(563,430)
(1,491,577)
93,538 
98,427 
22,467 
12,073 
— 
— 
— 
— 
— 
21,670 
(139,777)
(29,110)
(21,130)
52,206 
42,168 
(2,802)
228,133 
662,174 
(420,788)
(154,916)
(5,341)
42,641 
278,817 
26,925 
— 
1,156 
(231,506)
25,623 
(375,038)
(108,917)
— 
(458,332)
(12,117)
138,665 
961,474 
1,100,139  $
$
20,314 
— 
(51,122)
— 
(30,808)
10,480 
410,340 
551,134 
961,474  $
307 
78,990 
88,184 
18,475 
5,853 
— 
28,498 
7,528 
(6,792)
(15,769)
24,007 
(121,014)
(58,269)
(31,529)
22,099 
60,240 
14,611 
189,075 
747,270 
— 
(149,707)
(693,284)
290,754 
194,677 
21,820 
— 
(14,704)
(350,444)
17,907 
(399,999)
(57,675)
(45,773)
(485,540)
2,282 
(86,432)
637,566 
551,134 
The accompanying notes are an integral part of these consolidated financial statements.
62
 
 
ALIGN TECHNOLOGY, INC. AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
Note 1. Summary of Significant Accounting Policies
Business Description
Align Technology, Inc. (“We”, “Our”, or “Align”) was incorporated in April 1997 in Delaware. Align is a global medical device company primarily
engaged  in  the  design,  manufacture  and  marketing  of  Invisalign®  clear  aligners,  iTero®  intraoral  scanners,  services  for  orthodontics,  restorative  and
aesthetic  dentistry  and  exocad®  computer-aided  design  and  computer-aided  manufacturing  (“CAD/CAM”)  software  for  dental  laboratories  and  dental
practitioners. We also market and sell consumer products that are complementary to our doctor-prescribed principal products under the Invisalign brand,
including retainers, aligner cases (clamshells), teeth whitening products and cleaning solutions (crystals, foam and other material) (collectively “Consumer
Products”).  Our  primary  goal  is  to  establish  clear  aligners  as  the  principal  solution  for  the  treatment  of  malocclusions  and  our  Invisalign  system  as  the
treatment solution of choice by orthodontists, general dental practitioners and patients globally, our intraoral scanning platform as the preferred scanning
protocol for digital dental scans, and our exocad CAD/CAM software as the solution of choice for dental labs. Our corporate headquarters is located in
Tempe, Arizona, which moved from San Jose, California effective January 1, 2021, and we have offices worldwide. Our Americas regional headquarters is
located in Raleigh, North Carolina; our European, Middle East and Africa (“EMEA”) regional headquarters is located in Rotkreuz, Switzerland; and our
Asia Pacific (“APAC”) regional headquarters is located in Singapore. We have two operating segments: (1) Clear Aligner, known as the Invisalign system,
and (2) Imaging Systems and CAD/CAM services (“Systems and Services”), known as the iTero intraoral scanner and CAD/CAM services.
Basis of Presentation and Preparation
The consolidated financial statements include the accounts of Align and our wholly-owned subsidiaries after elimination of intercompany transactions
and balances.  
Out-of-Period Adjustments
For  the  year  ended  December  31,  2021  and  2020,  we  recorded  out-of-period  corrections  that  resulted  in  tax  benefits  of  $16.0  million  and
$12.7 million, respectively, in our Consolidated Statement of Operations. We do not believe these out-of-period adjustments are material to the interim or
annual consolidated financial statements for the respective reporting period or to any of the related prior periods.
Use of Estimates
The  preparation  of  financial  statements  in  conformity  with  generally  accepted  accounting  principles  (“GAAP”)  in  the  United  States  of  America
(“U.S.”)  requires  our  management  to  make  estimates  and  assumptions  that  affect  the  amounts  reported  in  the  consolidated  financial  statements  and
accompanying notes. Actual results could differ materially from those estimates. On an ongoing basis, we evaluate our estimates, including those related to
revenue recognition, useful lives of intangible assets and property and equipment, long-lived assets and goodwill, income taxes and contingent liabilities,
the fair values of financial instruments, stock-based compensation and valuation of investments in privately held companies among others. We base our
estimates  on  historical  experience  and  on  various  other  assumptions  that  are  believed  to  be  reasonable,  the  results  of  which  form  the  basis  for  making
judgments about the carrying values of assets and liabilities.
Fair Value of Financial Instruments
Fair value is an exit price, representing the amount that would be received from selling an asset or paid to transfer a liability in an orderly transaction
between  market  participants  at  the  measurement  date. We  use  the  GAAP  fair  value  hierarchy  that  prioritizes  the  inputs  to  valuation  techniques  used  to
measure  fair  value.  This  hierarchy  requires  an  entity  to  maximize  the  use  of  observable  inputs  and  minimize  the  use  of  unobservable  inputs  when
measuring fair value. The three levels of inputs that may be used to measure fair value:
Level 1 - Quoted (unadjusted) prices in active markets for identical assets or liabilities.
Level  2  -  Observable  inputs  other  than  quoted  prices  included  in  Level  1,  such  as  quoted  prices  for  similar  assets  or  liabilities  in  active  markets,
quoted  prices  for  identical  or  similar  assets  or  liabilities  in  markets  that  are  not  active,  or  other  inputs  that  are  observable  or  can  be  corroborated  by
observable market data for substantially the full term of the asset or liability. We obtain fair values for our Level 2 investments. Our custody bank and asset
managers independently use
63
    
professional pricing services to gather pricing data which may include quoted market prices for identical or comparable financial instruments, or inputs
other than quoted prices that are observable either directly or indirectly, and we are ultimately responsible for these underlying estimates.
Level  3  -  Unobservable  inputs  to  the  valuation  methodology  that  are  supported  by  little  or  no  market  activity  and  that  are  significant  to  the
measurement of the fair value of the assets or liabilities. Level 3 assets and liabilities include those whose fair value measurements are determined using
pricing models, discounted cash flow methodologies or similar valuation techniques, as well as significant management judgment or estimation.
Cash and Cash Equivalents
We consider currency on hand, demand deposits, time deposits, and all highly liquid investments with an original maturity of three months or less at
the date of purchase to be cash and cash equivalents. Cash and cash equivalents are held in various financial institutions in the U.S. and internationally.
Restricted Cash
The restricted cash primarily consists of funds reserved for legal requirements. Restricted cash balances are primarily included in other assets within
our Consolidated Balance Sheets.
Marketable Securities
Our  marketable  securities  consist  of  marketable  debt  securities  which  are  classified  as  available-for-sale  and  are  carried  at  fair  value.  Our  fixed-
income  securities  investment  portfolio  allows  for  investments  with  a  maximum  effective  maturity  of  up  to  40  months  on  any  individual  security.
Marketable securities classified as current assets have maturities within one year from the balance sheet date. Unrealized gains or losses on such securities
are included in accumulated other comprehensive income (loss), net in stockholders’ equity. Realized gains and losses from sales and maturities of all such
securities are reported in earnings and computed using the specific identification cost method. 
All of our marketable securities are subject to a periodic impairment review. We evaluate if an allowance for credit loss is necessary by considering
available  information  relevant  to  the  collectibility  of  the  security  and  information  about  credit  rating  changes,  past  events,  current  conditions,  and
reasonable and supportable forecasts. Any allowance for credit loss is recorded as a charge to other income (expense), net, in our Consolidated Statement of
Operations. If we have an intent to sell, or if it is more likely than not that we will be required to sell the security in an unrealized loss position before
recovery of its amortized cost basis, we will write down the security to its fair value and record the corresponding charge as a component of other income
(expense), net in our Consolidated Statement of Operations.
Variable Interest Entities
We  evaluate  whether  an  entity  in  which  we  have  made  an  investment  is  considered  a  variable  interest  entity  (“VIE”).  If  we  determine  we  are  the
primary beneficiary of a VIE, we would consolidate the VIE into our financial statements. In determining if we are the primary beneficiary, we evaluate
whether we have the power to direct the activities that most significantly impact the VIE’s economic performance and the obligation to absorb losses or the
right to receive benefits of the VIE that could potentially be significant to the VIE. Our evaluation includes identification of significant activities and an
assessment of our ability to direct those activities based on governance provisions and arrangements to provide or receive product and process technology,
product supply, operations services, equity funding, financing, and other applicable agreements and circumstances. Our assessments of whether we are the
primary  beneficiary  of  a  VIE  require  significant  assumptions  and  judgments.  We  have  concluded  that  we  are  not  the  primary  beneficiary  of  our  VIE
investments; therefore, we do not consolidate their results into our consolidated financial statements.
Investments in Privately Held Companies
Investments in privately held companies in which we can exercise significant influence but do not own a majority equity interest or otherwise control
are accounted for under the equity method. We record our share of their operating results within equity in losses of investee, net of tax, in our Consolidated
Statement of Operations.
Investments in privately held companies in which we cannot exercise significant influence and do not own a majority equity interest or otherwise
control are accounted for under the measurement alternative. Under the measurement alternative, the carrying value of our equity investment is adjusted to
fair  value  for  observable  transactions  for  identical  or  similar  investments  of  the  same  issuer.  Investments  in  equity  securities  are  reported  on  our
Consolidated Balance Sheet as other assets,
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and we periodically evaluate them for impairment. We record any change in carrying value of our equity securities, in other income (expense), net in our
Consolidated Statement of Operations.
Derivative Financial Instruments
We enter into foreign currency forward contracts to minimize the short-term impact of foreign currency exchange rate fluctuations associated with
certain assets and liabilities. These forward contracts are not designated as hedging instruments and do not subject us to material balance sheet risk due to
fluctuations in foreign currency exchange rates. The gains and losses on these forward contracts are intended to offset the gains and losses in the underlying
foreign  currency  denominated  monetary  assets  and  liabilities  being  economically  hedged.  We  do  not  enter  into  foreign  currency  forward  contracts  for
trading or speculative purposes. The net gain or loss from the settlement of these foreign currency forward contracts is recorded in other income (expense),
net in the Consolidated Statement of Operations.
Foreign Currency
For our international subsidiaries, we analyze on an annual basis or more often if necessary, if a significant change in facts and circumstances indicate
that the functional currency has changed. For international subsidiaries where the local currency is the functional currency, adjustments from translating
financial  statements  from  the  local  currency  to  the  U.S.  dollar  reporting  currency  are  recorded  as  a  separate  component  of  accumulated  other
comprehensive  income  (loss),  net  in  the  stockholders’  equity  section  of  the  Consolidated  Balance  Sheet.  This  foreign  currency  translation  adjustment
reflects the translation of the balance sheet at period end exchange rates, and the income statement at the transaction date or average exchange rate in effect
during the period. The foreign currency revaluation that are derived from monetary assets and liabilities stated in a currency other than functional currency
are included in other income (expense), net. For the year ended December 31, 2021, 2020 and 2019, we had foreign currency net gains (losses) of $(13.3)
million, $6.8 million and $(2.0) million, respectively.
Certain Risks and Uncertainties
Our operating results depend to a significant extent on our ability to market and develop our products. The life cycles of our products are difficult to
estimate  due,  in  part,  to  the  effect  of  future  product  enhancements  and  competition.  Our  inability  to  successfully  develop  and  market  our  products  as  a
result of competition or other factors would have a material adverse effect on our business, financial condition and results of operations.
The U.S. Food and Drug Administration (“FDA”) and similar international agencies regulate the design, manufacture, distribution, pre-clinical and
clinical  study,  clearance  and  approval  of  medical  devices.  Products  developed  by  us  may  require  approvals  or  clearances  from  the  FDA  or  other
international regulatory agencies prior to commercialized sales. There can be no assurance that our products will receive any of the required approvals or
clearances. If we were denied approval or clearance or such approval was delayed, it may have a material adverse impact on us.
Our  cash  and  investments  are  held  primarily  by  four  financial  institutions.  Financial  instruments  which  potentially  expose  us  to  concentrations  of
credit  risk  consist  primarily  of  cash  equivalents  and  marketable  securities. We  invest  excess  cash  primarily  in  money  market  funds,  commercial  paper,
certificates of deposits, corporate bonds, asset-backed securities, municipal bonds and U.S. government agency bonds and treasury bonds and periodically
evaluate them for credit losses. Such credit losses have not been material to our financial statements.
We  provide  credit  to  customers  in  the  normal  course  of  business.  Collateral  is  not  required  for  accounts  receivable  but  ongoing  evaluations  of
customers’  credit  worthiness  are  performed.  We  maintain  an  allowance  for  potential  credit  losses  for  uncollectible  accounts  and  such  losses  have  been
within management’s expectations. No individual customer accounted for 10% or more of our accounts receivable at December 31, 2021 or 2020 or net
revenues for the year ended December 31, 2021, 2020 or 2019.
We have manufacturing facilities located in Juarez, Mexico where we conduct our aligner fabrication, distribution and perform certain services and in
Ziyang, China where we fabricate aligners primarily for China and other APAC markets. In addition, we produce our handheld intraoral scanner wand,
perform final scanner assembly and repair our scanners at our facilities in Ziyang, China and Or Yehuda, Israel and service and repair certain scanners in
Juarez, Mexico. In the second quarter of 2021, we announced the start of a multi-million dollar project to bring operational facilities closer to our customers
through the expansion of our manufacturing operations in Wroclaw, Poland. Expected to begin serving doctors during the first half of 2022, the new aligner
fabrication facility will be our third and allow us to more quickly and effectively serve tens of thousands of customers throughout EMEA. Additionally, in
the third quarter of 2021, we opened our multi-story iTero scanner and services facilities in Petach Tikva, Israel to further the design and development of
our portfolio of iTero intraoral scanners, imaging systems and services. Our digital treatment plans using a sophisticated, internally developed computer-
modeling
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program are located in multiple international locations to support our customers within the regions. Our reliance on international operations exposes us to
related  risks  and  uncertainties,  including  difficulties  in  staffing  and  managing  international  operations  such  as  hiring  and  retaining  qualified  personnel;
controlling production volume and quality of manufacture; political, social and economic instability; interruptions and limitations in telecommunication
services;  product  and  material  transportation  delays  or  disruption;  trade  restrictions  and  changes  in  tariffs;  import  and  export  license  requirements  and
restrictions;  fluctuations  in  foreign  currency  exchange  rates;  and  potential  adverse  tax  consequences.  If  any  of  these  risks  materialize,  our  international
manufacturing operations, as well as our operating results, may be harmed.
We  purchase  certain  inventory  from  sole  suppliers.  Additionally,  we  rely  on  a  limited  number  of  hardware  manufacturers.  The  inability  of  any
supplier or manufacturer to fulfill our supply requirements could materially and adversely impact our future operating results.
Due  to  the  COVID-19  pandemic,  we  are  subject  to  a  greater  degree  of  uncertainty  than  normal  in  making  the  judgments  and  estimates  needed  to
apply  our  significant  accounting  policies.  The  full  extent  to  which  the  pandemic,  including  as  a  result  of  any  new  variants,  business  restrictions  or
lockdowns, and the impact of vaccinations, will directly or indirectly impact our business, results of operations, cash flows, and financial condition will
depend on future developments that are highly uncertain and cannot be accurately determined. Further, we could also be materially adversely affected by
supply chain disruptions, including shortages and inflationary pressures, uncertain or reduced demand, labor shortages, delays in collection of outstanding
receivables and the impact of any initiatives or programs that we may undertake to address financial and operational challenges faced by our customers.
Accounts Receivable, net
Trade accounts receivable are recorded at the invoiced amount. Accounts receivable, net includes allowances for doubtful accounts for any potentially
uncollectible amounts. We periodically assess the adequacy of the allowance for doubtful accounts by reviewing the accounts receivable on a collective
basis by considering factors such as aging of the receivables and customers’ expected ability to pay, and on an individual basis for specific customers with
known  disputes  or  collectability  issues.  In  determining  the  amount  of  the  allowance  for  doubtful  accounts,  we  also  evaluate  the  creditworthiness  of
customers, current market conditions and forecasts of future economic conditions to make any adjustments. Actual write-offs have not materially differed
from the estimated allowances.
Inventories
Inventories are valued at the lower of cost or net realizable value, with cost computed using standard cost which approximates actual cost on a first-
in-first-out  basis.  Excess  and  obsolete  inventories  are  determined  primarily  based  on  future  demand  forecasts,  and  write-downs  of  excess  and  obsolete
inventories are recorded as a component of cost of net revenues.
Property, Plant and Equipment, net
Property,  plant  and  equipment,  net  are  stated  at  historical  cost  less  accumulated  depreciation  and  amortization.  Depreciation  and  amortization  are
computed using the straight-line method over the estimated useful lives of the assets. Construction in progress is related to the construction or development
of property (including land) and equipment that have not yet been placed in service for their intended use. Upon sale or retirement, the asset’s cost and
related accumulated depreciation are removed from the balance sheet and any related gains or losses are reflected in income from operations. Maintenance
and  repairs  are  expensed  as  incurred.  Refer  to  Note  3  "Balance  Sheet  Components"  of  the  Notes  of  Consolidated  Financial  Statements  for  details  on
estimated useful lives.
Leases
We determine if an arrangement is a lease at inception. Leases with a term of 12 months or less are not recorded on the balance sheet. Right-of-use
(“ROU”) assets represent our right to use an underlying asset for the lease term and lease liabilities represent our obligation to make lease payments arising
from the lease. ROU assets and liabilities are recognized at commencement date based on the present value of lease payments over the lease term. We use
our incremental borrowing rate based on the information available at commencement date in determining the present value of lease payments as the rate
implicit in our leases is not readily determinable. We determine lease terms as the noncancellable period of the lease and may include options to extend or
terminate the lease when it is reasonably certain that we will exercise that option. We have lease agreements with lease and non-lease components which
are  accounted  for  as  a  single  lease  component.  Payments  under  our  lease  arrangements  are  primarily  fixed;  however,  certain  lease  agreements  contain
variable payments which are expensed as incurred and not included in the operating lease ROU assets and liabilities.
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Business Combinations
We  allocate  the  fair  value  of  the  purchase  consideration  to  the  assets  acquired  and  liabilities  assumed  based  on  their  estimated  fair  values  at  the
acquisition  date.  When  determining  the  fair  value  of  assets  acquired  and  liabilities  assumed,  management  is  required  to  make  certain  estimates  and
assumptions, especially with respect to intangible assets. The estimates and assumptions used in valuing intangible assets include, but are not limited to, the
amount and timing of projected future cash flows including forecasted revenues, the discount rate used to determine the present value of these cash flows,
and the determination of the assets’ life cycle. Amounts recorded in a business combination may change during the measurement period, which is a period
not to exceed one year from the date of acquisition, as additional information about conditions existing at the acquisition date becomes available.
Goodwill and Finite-Lived Acquired Intangible Assets
Goodwill represents the excess of the purchase price paid over the fair value of tangible and identifiable intangible net assets acquired in business
combinations and is allocated to the respective reporting units based on relative synergies generated.
Our  intangible  assets  primarily  consist  of  intangible  assets  acquired  as  part  of  our  acquisitions.  These  assets  are  amortized  using  the  straight-line
method over their estimated useful lives ranging from one to fifteen years reflecting the period in which the economic benefits of the assets are expected to
be realized.
Impairment of Goodwill and Long-Lived Assets
Goodwill
We evaluate goodwill for impairment at least annually on November 30th or more frequently if indicators are present, an event occurs or changes in
circumstances  suggest  an  impairment  may  exist  and  that  it  would  more  likely  than  not  reduce  the  fair  value  of  a  reporting  unit  below  its  carrying
amount. The allocation of goodwill to the respective reporting unit is based on relative synergies generated as a result of an acquisition.  
We perform an initial assessment of qualitative factors to determine whether the existence of events and circumstances leads to a determination that it
is more likely than not that the fair value of a reporting unit is less than its carrying amount. In performing the qualitative assessment, we identify and
consider the significance of relevant key factors, events, and circumstances that affect the fair value of our reporting units. These factors include external
factors such as macroeconomic, industry, and market conditions, as well as entity-specific factors, such as our actual and planned financial performance.
We also give consideration to the difference between the reporting unit fair value and carrying value as of the most recent date a fair value measurement
was performed. If, after assessing the totality of relevant events and circumstances, we determine that it is more likely than not that the fair value of the
reporting unit exceeds its carrying value and there is no indication of impairment, no further testing is performed; however, if we conclude otherwise, then
we will perform the quantitative impairment test which compares the estimated fair value of the reporting unit to its carrying value, including goodwill. If
the carrying amount of the reporting unit is in excess of its fair value, an impairment loss would be recorded in the Consolidated Statement of Operations.
Long-Lived Assets
We evaluate long-lived assets (including finite-lived intangible assets) for impairment whenever events or changes in circumstances indicate that the
carrying  amount  of  an  asset  group  may  not  be  recoverable. An  asset  or  asset  group  is  considered  impaired  if  its  carrying  amount  exceeds  the  future
undiscounted net cash flows that the asset or asset group is expected to generate. Factors we consider important which could trigger an impairment review
include  significant  negative  industry  or  economic  trends,  significant  loss  of  customers  and  changes  in  the  competitive  environment.  If  an  asset  or  asset
group is considered to be impaired, the impairment to be recognized is calculated as the amount by which the carrying amount of the asset or asset group
exceeds its fair market value. Our estimates of future cash flows attributable to our long-lived assets require significant judgment based on our historical
and  anticipated  results  and  are  subject  to  many  assumptions.  The  estimation  of  fair  value  utilizing  a  discounted  cash  flow  approach  includes  numerous
uncertainties  which  require  our  significant  judgment  when  making  assumptions  of  expected  growth  rates  and  the  selection  of  discount  rates,  as  well  as
assumptions regarding general economic and business conditions, and the structure that would yield the highest economic value, among other factors. Refer
to Note 6 “Goodwill and Intangible Assets” of Notes to Consolidated Financial Statements for details on intangible long-lived assets.
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Development Costs for Internal Use Software
Internally developed software includes enterprise-level business software that we customize to meet our specific operational needs. Such capitalized
costs include external direct costs utilized in developing or obtaining the applications and payroll and payroll-related costs for employees, who are directly
associated with the development of the applications. There were no significant internally developed software costs capitalized in 2021 or 2020.
The  costs  to  develop  software  that  is  marketed  externally  have  not  been  capitalized  as  we  believe  our  current  software  development  process  is
essentially  completed  concurrent  with  the  establishment  of  technological  feasibility.  As  such,  all  related  software  development  costs  are  expensed  as
incurred and included in research and development expense in our Consolidated Statement of Operations.
Product Warranty
We offer assurance warranties on our products which provide the customer assurance that the product will function as the parties intended because it
complies  with  agreed-upon  specifications;  therefore,  warranties  are  not  treated  as  a  separate  revenue  performance  obligation  and  are  accounted  for  as
guarantees under GAAP.
Clear Aligner
We warrant our Invisalign products against material defects until the treatment plan is complete except in the case of retainers, which are warranted
up to three months from expected first use. We accrue for warranty costs, which are primarily based on historical experience as to product failures as well
as current information on replacement costs.
Systems and Services
We warrant our intraoral scanners for a period of one year, which includes materials and labor. We accrue for these warranty costs based on average
historical repair costs. An extended warranty may be purchased for additional fees. We warrant our CAD/CAM software for a one year period to perform in
accordance  with  agreed  product  specifications.  As  we  have  not  historically  incurred  any  material  warranty  costs,  we  do  not  accrue  for  these  software
warranties.
Warranty costs are recorded in cost of net revenues upon shipment of products. We regularly review our warranty liability and update these balances
based on historical warranty cost trends. Actual warranty costs incurred have not materially differed from those accrued; however future actual warranty
costs could differ from the estimated amounts.
Revenue Recognition
Our revenues are derived primarily from the sale of aligners, scanners, and services from our Clear Aligner and Systems and Services segments. We
enter into sales contracts that may consist of multiple distinct performance obligations where certain performance obligations of the sales contract are not
delivered in one reporting period. We measure and allocate revenues according to ASC 606-10, “Revenues from Contracts with Customers.”
We identify a performance obligation as distinct if both of the following criteria are met: the customer can benefit from the good or service either on
its own or together with other resources that are readily available to the customer and the entity’s promise to transfer the good or service to the customer is
separately identifiable from other promises in the contract. Determining the standalone selling price (“SSP”), allocation of consideration from the contract
to  the  individual  performance  obligations  and  the  appropriate  timing  of  revenue  recognition  is  the  result  of  significant  qualitative  and  quantitative
judgments.  While  changes  in  the  allocation  of  the  SSP  between  performance  obligations  will  not  affect  the  amount  of  total  revenues  recognized  for  a
particular contract, any material changes could impact the timing of revenue recognition, which would have a material effect on our financial position and
result of operations. This is because the contract consideration is allocated to each performance obligation, delivered or undelivered, at the inception of the
contract based on the SSP of each distinct performance obligation.
Clear Aligner
We  enter  into  contracts  (“treatment  plan(s)”)  that  involve  multiple  future  performance  obligations.  Invisalign  Comprehensive,  Invisalign  First,
Invisalign Moderate, and Lite and Express Packages include optional additional aligners at no charge for a certain period of time ranging from six months
to five years after initial shipment, and Invisalign Go and Invisalign Go Plus includes optional additional aligners at no charge for a period of up to two
years after initial shipment.
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Our treatment plans comprise the following performance obligations that also represent distinct deliverables: initial aligners, the option of additional
aligners,  case  refinement,  and  replacement  aligners.  We  take  the  practical  expedient  to  consider  shipping  and  handling  costs  as  activities  to  fulfill  the
performance obligation. We allocate revenues for each treatment plan based on each unit’s SSP. Management considers a variety of factors such as same or
similar  product  historical  sales,  costs,  and  gross  margin,  which  may  vary  over  time  depending  upon  the  unique  facts  and  circumstances  related  to  each
performance obligation in making these estimates. We also consider usage rates, which is the number of times a customer is expected to order additional
aligners. Our process for estimating usage rates requires significant judgment and evaluation of inputs, including historical usage data by region, country
and channel. We recognize the revenues upon shipment, as the customers obtain physical possession and we have enforceable rights to payment. As we
collect most consideration upfront, we consider whether a significant financing component exists; however, as the delivery of the performance obligations
are at the customer’s discretion, we conclude that no significant financing component exists.
Systems and Services
We  sell  intraoral  scanners  and  CAD/CAM  services  through  both  our  direct  sales  force  and  distribution  partners.  The  intraoral  scanner  sales  price
includes  one  year  of  warranty  and  unlimited  scanning  services.  The  customer  may  also  select,  for  additional  fees,  extended  warranty  and  unlimited
scanning  services  for  periods  beyond  the  initial  year.  When  intraoral  scanners  are  sold  with  an  unlimited  scanning  service  agreement  and/or  extended
warranty, we allocate revenues based on the respective SSP of the scanner and the subscription service. We estimate the SSP of each element, taking into
consideration same or similar historical prices as well as our discounting strategies. Revenues are then recognized over time as the monthly services are
rendered and upon shipment of the scanner, as that is when we deem the customer to have obtained control. CAD/CAM services, where sold separately,
include  the  initial  software  license  and  maintenance  and  support.  We  allocate  revenues  based  upon  the  respective  SSPs  of  the  software  license  and  the
maintenance and support. We estimate the SSP of each element using historical prices. Revenues related to the software license are recognized upfront and
revenues related to the maintenance and support are recognized over time. For both scanner and service sales, most consideration is collected upfront and in
cases where there are payment plans, consideration is collected within one year and, therefore, there are no significant financing components.
Volume Discounts
In certain situations, we offer promotions in which the discount will increase depending upon the volume purchased over time. We concluded that in
these  situations,  the  promotions  can  represent  either  variable  consideration  or  options,  depending  upon  the  specifics  of  the  promotion.  In  the  event  the
promotion contains an option, the option is considered a material right and, therefore, included in the accounting for the initial arrangement. We estimate
the average anticipated discount over the lifetime of the promotion or contract, and apply that discount to each unit as it is sold. On a quarterly basis, we
review our estimates and, if needed, updates are made and changes are applied prospectively.
Accrued Sales Return Reserve
We provide a reserve for sales returns based on historical sales returns as a percentage of revenues. 
Costs to Obtain a Contract
We offer a variety of commission plans to our salesforce; each plan has multiple components. To match the costs to obtain a contract to the associated
revenues,  we  evaluate  the  individual  components  and  capitalize  the  eligible  components,  recognizing  the  costs  over  the  treatment  period.  The  costs  to
obtain contracts were $31.1 million and $22.8 million as of December 31, 2021 and 2020, respectively, and are included in other assets in our Consolidated
Balance  Sheets.  We  recognized  amortization  on  our  costs  to  obtain  a  contract  of  $17.0  million,  $10.1  million,  and  $7.2  million  during  the  year  ended
December  31,  2021,  2020,  and  2019,  respectively,  which  is  included  in  selling,  general  and  administrative  expenses  in  our  Consolidated  Statements  of
Operations.
Unfulfilled Performance Obligations for Clear Aligners and Scanners
Our unfulfilled performance obligations, including deferred revenues and backlog, as of December 31, 2021 and the estimated revenues expected to
be recognized in the future related to these performance obligations are $1,307.3 million. This includes performance obligations from the Clear Aligner
segment, primarily the shipment of additional aligners, which are fulfilled over six months to five years. This also includes the performance obligations
from the Systems and Services segment, primarily services and support, which are fulfilled over one to five years, and contracted deliveries of additional
scanners. The estimate includes both product and service unfulfilled performance obligations and the time range reflects our best estimate of
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when we will transfer control to the customer and may change based on customer usage patterns, timing of shipments, readiness of customers' facilities for
installation, and manufacturing availability.
Contract Balances
The timing of revenue recognition results in deferred revenues being recognized on our Consolidated Balance Sheet. For both aligners and scanners,
we usually collect the total consideration owed prior to all performance obligations being performed with payment terms generally varying from net 30 to
net 180 days. Contract liabilities are recorded as deferred revenue balances, which are generated based upon timing of invoices and recognition patterns,
not payments. If the revenue recognition exceeds the billing, the exceeded amount is considered unbilled receivable and a contract asset. Conversely, if the
billing occurs prior to the revenue recognition, the amount is considered deferred revenue and a contract liability.
Shipping and Handling Costs
Shipping and handling charges to customers are included in net revenues, and the associated costs incurred are recorded in cost of net revenues.
Legal Proceedings and Litigations
We  are  involved  in  legal  proceedings  on  an  ongoing  basis.  If  we  believe  that  a  loss  arising  from  such  matters  is  probable  and  can  be  reasonably
estimated,  we  accrue  the  estimated  loss  in  our  consolidated  financial  statements.  If  only  a  range  of  estimated  losses  can  be  determined,  we  accrue  an
amount within the range that, in our judgment, reflects the most likely outcome; if none of the estimates within that range is a better estimate than any other
amount, we accrue the low end of the range.
Research and Development
Research and development costs are expensed as incurred and includes the costs associated with the research and development of new products and
enhancements  to  existing  products.  These  costs  primarily  include  personnel-related  costs,  including  payroll  and  stock-based  compensation,  equipment,
material  and  maintenance  costs,  outside  consulting  expenses,  depreciation  and  amortization  expense  and  allocations  of  corporate  overhead  expenses
including facilities and information technology (“IT”).
Advertising Costs
The cost of advertising and media is expensed as incurred. For the year ended December 31, 2021, 2020 and 2019, we incurred advertising costs of
$325.6 million, $161.0 million and $119.1 million, respectively.
Stock-Based Compensation
We recognize stock-based compensation cost for shares expected to vest on a straight-line basis over the requisite service period of the award, net of
estimated forfeitures. We use the Black-Scholes option pricing model to determine the fair value of stock awards and employee stock purchase plan shares.
We use a Monte Carlo simulation model to estimate the fair value of market-performance based restricted stock units (“MSUs”) which requires the input of
assumptions, including expected term, stock price volatility and the risk-free rate of return. In addition, judgment is also required in estimating the number
of  stock-based  awards  that  are  expected  to  be  forfeited.  Forfeitures  are  estimated  based  on  historical  experience  at  the  time  of  grant  and  revised,  if
necessary, in subsequent periods if actual forfeitures differ from those estimates. The assumptions used in calculating the fair value of share-based payment
awards  represent  management’s  best  estimates,  but  these  estimates  involve  inherent  uncertainties  and  the  application  of  management’s  judgment. As  a
result, if factors change and we use different assumptions, our stock-based compensation expense could be materially different in the future.
Income Taxes
We make certain estimates and judgments in determining income tax expense for financial statement purposes. These estimates and judgments occur
in  the  calculation  of  certain  tax  assets  and  liabilities,  which  arise  from  differences  in  the  timing  of  recognition  of  revenues  and  expenses  for  tax  and
financial statement purposes.
As part of the process of preparing our consolidated financial statements, we are required to estimate our income taxes in each of the jurisdictions in
which we operate. This process involves us estimating our current tax exposure under the applicable
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tax  laws  and  assessing  temporary  differences  resulting  from  differing  treatment  of  items  for  tax  and  accounting  purposes.  These  differences  result  in
deferred tax assets and liabilities which are included in our Consolidated Balance Sheets.
We account for uncertainty in income taxes pursuant to authoritative guidance based on a two-step approach to recognize and measure uncertain tax
positions taken or expected to be taken in a tax return. The first step is to determine if the weight of available evidence indicates that it is more likely than
not that the tax position will be sustained on audit based on its technical merits, including resolution of any related appeals or litigation processes. The
second step is to measure the tax benefit as the largest amount that is more than 50% likely to be realized upon ultimate settlement. We adjust reserves for
our uncertain tax positions due to changing facts and circumstances, such as the closing of a tax audit or refinement of estimates due to new information. To
the extent that the final outcome of these matters is different than the amounts recorded, such differences will impact our tax provision in our Consolidated
Statement of Operation in the period in which such determination is made.
We assess the likelihood that we will be able to realize our deferred tax assets. Should there be a change in our ability to realize our deferred tax
assets, our tax provision would increase in the period in which we determine that it is more likely than not that we cannot realize our deferred tax assets.
We consider all available evidence, both positive and negative, including historical levels of income, expectations and risks associated with estimates of
future taxable income and ongoing prudent and feasible tax planning strategies in assessing the need for a valuation allowance. If it is more likely than not
that we will not realize our deferred tax assets, we will increase our provision for taxes by recording a valuation allowance against the deferred tax assets
that we estimate will not ultimately be realizable.
During fiscal 2020, we completed an intra-entity transfer of certain intellectual property rights and fixed assets to our Swiss subsidiary, which resulted
in the recognition of deferred tax assets and related tax benefits. Refer to Note 15 “Income Taxes” of Notes to Consolidated Financial Statements for more
information.  The  establishment  of  deferred  tax  assets  from  the  intra-entity  transfer  of  intangible  assets  required  us  to  make  significant  estimates  and
assumptions to determine the fair value of intellectual property rights transferred which include, but are not limited to, our expectations of growth rates in
revenue, margins, future cash flows, and discount rates. The accuracy of these estimates could be affected by unforeseen events or actual results, and the
sustainability of our future tax benefits is dependent upon the acceptance of these valuation estimates and assumptions by the taxing authorities.
The  U.S.  Tax  Cuts  and  Jobs  Act  includes  provisions  for  certain  foreign-sourced  earnings  referred  to  as  Global  Intangible  Low-Taxed  Income
(“GILTI”) which imposes a tax on foreign income in excess of a deemed return on tangible assets of foreign corporations. We have made the election to
record GILTI tax using the period cost method.
Common Stock Repurchase
We repurchase our own common stock from time to time under stock repurchase programs approved by our Board of Directors. We account for these
repurchases under the accounting guidance for equity where we allocate the total repurchase value that is in excess over par value between additional paid-
in capital and retained earnings. All shares repurchased are retired.
Recent Accounting Pronouncements
(i) New Accounting Updates Recently Adopted
In December 2019, the Financial Accounting Standards Board (“FASB”) issued Accounting Standard Update (“ASU”) 2019-12, “Income Taxes (Topic
740)  Simplifying  the  Accounting  for  Income  Taxes,” to  enhance  and  simplify  various  aspects  of  the  income  tax  accounting  guidance.  The  amendment
removes certain exceptions to the general principles in Topic 740 and also clarifies and amends existing guidance to improve consistent application. The
amendments are effective for fiscal years and interim periods within those fiscal years beginning after December 15, 2020. Adoption of this standard in the
first quarter of fiscal year 2021 did not have a material impact on our consolidated financial statements or related disclosures.
(ii) Recent Accounting Updates Not Yet Effective
We  continue  to  monitor  new  accounting  pronouncements  issued  by  the  FASB  and  do  not  believe  any  of  the  recently  issued  accounting
pronouncements will have an impact on our consolidated financial statements or related disclosures.
71
Note 2. Financial Instruments
Cash, Cash Equivalents and Marketable Securities
The  following  table  summarizes  our  cash  and  cash  equivalents,  and  marketable  securities  on  our  Consolidated  Balance  Sheet  as  of  December  31,
2021 (in thousands):
December 31, 2021
Cash
Money market funds
Corporate bonds
U.S. government treasury bonds
Asset-backed securities
Municipal bonds
U.S. government agency bonds
Total
Amortized
Cost
754,802  $
343,012 
115,507 
42,976 
32,031 
7,628 
1,201 
1,297,157  $
$
$
Gross
Unrealized
Gains
Gross
Unrealized
Losses
Fair Value
Cash and Cash
Equivalents
Reported as:
Marketable
securities, short-
term
Marketable
securities, long-
term
—  $
— 
9 
— 
— 
— 
— 
9  $
—  $
(2)
(398)
(48)
(40)
(15)
(1)
(504) $
754,802  $
343,010 
115,118 
42,928 
31,991 
7,613 
1,200 
1,296,662  $
754,802  $
343,010 
1,042 
— 
— 
516 
— 
1,099,370  $
—  $
— 
35,065 
22,251 
10,999 
3,657 
— 
71,972  $
— 
— 
79,011 
20,677 
20,992 
3,440 
1,200 
125,320 
As  of  December  31,  2020,  we  held  $441.6  million  of  cash  and  $519.2  million  of  money  market  funds  which  were  reported  as  cash  and  cash
equivalents  on  our  Consolidated  Balance  Sheet.  We  had  no  short-term  or  long-term  marketable  securities  as  of  December  31,  2020.  Net  realized  and
unrealized gains and losses were not material for the year ended December 31, 2021, 2020 and 2019.
The following table summarizes the fair value of our available-for-sale marketable securities classified by contractual maturity as of December 31,
2021 (in thousands):
Due in 1 year or less
Due in 1 year through 5 years
Total
December 31, 2021
$
$
59,737 
139,113 
198,850 
The  securities  that  we  invest  in  are  generally  deemed  to  be  low  risk  based  on  their  credit  ratings  from  the  major  rating  agencies.  The  longer  the
duration of these securities, the more susceptible they are to changes in market interest rates and bond yields. As interest rates increase, those securities
purchased at a lower yield show a mark-to-market unrealized loss. Our unrealized losses as of December 31, 2021 are primarily due to changes in interest
rates and credit spreads. We had no marketable securities that have been in a continuous material unrealized loss position for greater than twelve months as
of December 31, 2021.
72
Fair Value Measurements
The following tables summarize our financial assets measured at fair value as of December 31, 2021 and 2020 (in thousands):
Description
Cash equivalents:
Money market funds
Corporate bonds
Municipal bonds
Short-term investments:
U.S. government treasury bonds
Corporate bonds
Municipal bonds
Asset-backed securities
Long-term investments:
U.S. government treasury bonds
Corporate bonds
Municipal bonds
U.S. government agency bonds
Asset-backed securities
Prepaid expenses and other current assets:
Israeli funds
Other assets:
1
Investments in privately held companies 
Balance as of December
31, 2021
Level 1
Level 2
Level 3
$
$
343,010  $
1,042 
516 
343,010  $
— 
— 
—  $
1,042 
516 
22,251 
35,065 
3,657 
10,999 
20,677 
79,011 
3,440 
1,200 
20,992 
3,841 
22,251 
— 
— 
— 
20,677 
— 
— 
— 
— 
— 
— 
35,065 
3,657 
10,999 
— 
79,011 
3,440 
1,200 
20,992 
3,841 
— 
— 
— 
— 
— 
— 
— 
— 
— 
— 
— 
— 
— 
8,621 
554,322  $
— 
385,938  $
— 
159,763  $
8,621 
8,621 
1
    The adjustment to the carrying value of our equity investments in privately held companies without readily determinable fair value are not material during the
year ended December 31, 2021, 2020 and 2019.
Description
Cash equivalents:
Money market funds
Prepaid expenses and other current assets:
Israeli funds
Current unsecured promissory note
Balance as of December
31, 2020
Level 1
Level 2
Level 3
$
$
519,228  $
519,228  $
— 
3,500 
5,408 
528,136  $
— 
— 
519,228  $
3,500 
— 
3,500  $
— 
— 
5,408 
5,408 
Derivatives Not Designated as Hedging Instruments
Recurring foreign currency forward contracts
We enter into foreign currency forward contracts to minimize the short-term impact of foreign currency exchange rate fluctuations on certain trade
and intercompany receivables and payables. These forward contracts are classified within Level 2 of the fair value hierarchy. As a result of the settlement
of foreign currency forward contracts, during the year ended December 31, 2021, 2020 and 2019, we recognized a net gain of $18.8 million, a net loss of
$22.1  million  and  a  net  gain  of  $3.2  million,  respectively.  As  of  December  31,  2021  and  2020,  the  fair  value  of  foreign  exchange  forward  contracts
outstanding were not material.
73
The following table presents the gross notional value of all our foreign exchange forward contracts outstanding as of December 31, 2021 and 2020 (in
thousands):
Euro
Canadian Dollar
Chinese Yuan
Polish Zloty
Brazilian Real
Japanese Yen
British Pound
Israeli Shekel
Mexican Peso
Swiss Franc
Australian Dollar
Euro
Chinese Yuan
Canadian Dollar
British Pound
Japanese Yen
Brazilian Real
Israeli Shekel
Mexican Peso
Australian Dollar
Swiss Franc
December 31, 2021
Local Currency
Amount
Notional Contract
Amount (USD)
€165,110 $
C$99,800
¥494,500
PLN219,800
R$286,500
¥5,548,700
£34,740
ILS54,110
M$311,500
CHF9,950
A$6,900
$
186,358 
78,018 
77,358 
54,014 
50,894 
48,206 
46,881 
17,416 
15,133 
10,883 
5,009 
590,170 
December 31, 2020
Local Currency
Amount
Notional Contract
Amount (USD)
€126,300 $
¥936,000
C$65,000
£32,300
¥4,249,000
R$142,000
ILS74,000 
M$140,000
A$5,800
CHF3,700
$
155,125 
143,393 
50,791 
43,879 
41,222 
27,264 
23,094 
7,002 
4,447 
4,191 
500,408 
Other foreign currency forward contract
Prior to the closing of the exocad acquisition on April 1, 2020, we entered into a Euro foreign currency forward contract with a notional contract
amount  of  €376.0  million.  Relating  to  this  forward  contract,  in  2020,  we  recognized  a  loss  of  $10.2  million  within  other  income  (expense),  net  in  our
Consolidated Statement of Operations.
Note 3. Balance Sheet Components
Inventories consist of the following (in thousands): 
Raw materials
Work in progress
Finished goods
Total inventories
December 31,
2021
2020
$
$
123,234  $
51,706 
55,290 
230,230  $
76,404 
31,393 
31,440 
139,237 
74
Prepaid expenses and other current assets consist of the following (in thousands): 
Prepaid expenses
Other current assets
Total prepaid expenses and other current assets
Property, plant and equipment consist of the following (in thousands):
Clinical and manufacturing equipment
Building
Leasehold improvements
Computer software and hardware
Land
Furniture, fixtures and other
Construction in progress
Total
Less: Accumulated depreciation and impairment charges
Total property, plant and equipment, net
December 31,
2021
2020
$
$
70,218  $
125,087 
195,305  $
30,069 
61,685 
91,754 
Generally Used Estimated
Useful Life
Up to 10 years
20 years
1
Lease term 
3 years
—
2-5 years
—
December 31,
2021
2020
$
$
452,876  $
310,344 
61,289 
117,986 
58,869 
71,977 
367,686 
1,441,027 
(359,101)
1,081,926  $
372,077 
244,166 
63,541 
108,068 
34,598 
50,031 
163,492 
1,035,973 
(301,252)
734,721 
    Shorter of the remaining lease term or the estimated useful lives of the assets
1
Depreciation was $92.1 million, $80.1 million and $73.1 million for the year ended December 31, 2021, 2020 and 2019, respectively.
Accrued liabilities consist of the following (in thousands): 
Accrued payroll and benefits
Accrued expenses
Accrued property, plant and equipment
Accrued sales and marketing expenses
Accrued professional fees
Accrued income taxes
Current operating lease liabilities
Other accrued liabilities
Total accrued liabilities
December 31,
2021
2020
$
$
288,355  $
67,169 
46,561 
41,387 
31,457 
33,838 
22,719 
75,829 
607,315  $
170,106 
42,536 
27,692 
34,488 
20,617 
30,130 
21,735 
58,278 
405,582 
Accrued warranty as of December 31, 2021 and 2020, which is included in the “Other accrued liabilities” category of the accrued liabilities table
above, consists of the following activity (in thousands):
Accrued warranty as of December 31, 2019
Charged to cost of net revenues
Actual warranty expenditures
Accrued warranty as of December 31, 2020
Charged to cost of net revenues
Actual warranty expenditures
Accrued warranty as of December 31, 2021
$
$
11,205 
12,581 
(11,171)
12,615 
18,213 
(14,659)
16,169 
75
 
 
Deferred revenues consist of the following (in thousands):
Deferred revenues - current
Deferred revenues - long-term 
1
1
    Included in Other long-term liabilities within our Consolidated Balance Sheet
December 31,
2021
2020
$
1,152,870  $
136,684 
777,887 
62,551 
During the year ended December 31, 2021 and 2020, we recognized $3,952.6 million and $2,471.9 million of net revenues, respectively, of which
$481.1 million and $341.9 million was included in the deferred revenues balance at December 31, 2020 and December 31, 2019, respectively.
Note 4. Leases
We  have  operating  leases  for  manufacturing  facilities,  office  and  retail  spaces,  vehicles  and  office  equipment.  The  components  of  lease  expenses
consist of following (in thousands):
Lease Cost
1
Operating lease cost 
2
Variable lease cost 
Total lease cost
Year Ended December 31,
2021
2020
2019
$
$
33,241  $
11,134 
44,375  $
27,825  $
1,429 
29,254  $
22,778 
1,899 
24,677 
    Includes expense associated with short term leases of less than 12 months which is not material
1
        Includes  payments  related  to  agreements  with  embedded  leases  that  are  not  otherwise  reflected  on  the  balance  sheet.  These  costs  are  associated  with  our
2
manufacturing supply arrangements and fluctuate based on factory output and material price changes.
The following table provides a summary of our operating lease terms and discount rates:
Remaining Lease Term and Discount Rate
Weighted average remaining lease term (in years)
Weighted average discount rate
December 31,
2021
2020
7.8
3.2 %
7.4
4.2 %
As of December 31, 2021, the future payments related to our operating lease liabilities are as follows (in thousands):
Fiscal Year Ending December 31,
2022
2023
2024
2025
2026
Thereafter
Total lease payments
Less: Imputed interest
Total lease liabilities
Operating Leases
26,035 
24,620 
18,284 
15,517 
13,113 
45,461 
143,030 
(17,655)
125,375 
$
$
As  of  December  31,  2021,  we  had  additional  leases  that  have  not  yet  commenced  with  future  lease  payments  of  $17.8  million.  These  leases  will
commence during 2022 with non-cancelable lease terms of two to seven years.
Note 5. Business Combination
On April 1, 2020, we completed the acquisition of privately-held exocad for a total purchase consideration of $430.0 million and exocad became a
wholly-owned  subsidiary.  exocad  is  a  German  dental  CAD/CAM  software  company  that  offers  fully  integrated  workflows  to  dental  labs  and  dental
practices.
76
The allocation of purchase price to assets acquired and liabilities assumed based on estimated fair values is as follows (in thousands):
1
Goodwill 
Identified intangible assets
Cash and cash equivalents
Deferred tax liabilities
Other assets (liabilities), net
Total
1    
None of this goodwill is deductible for tax purposes.
The following table presents details of the identified intangible assets acquired (in thousands, except years):
$
$
340,181 
118,700 
9,190 
(35,419)
(2,674)
429,978 
Intangible assets subject to amortization:
  Existing technology
  Customer relationships
  Tradenames
Intangible assets not subject to amortization:
  In-process Research and Development (“IPR&D”)
Total intangible assets
Weighted Average
Amortization Period (in
years)
Fair Value
10 $
10
7
N/A
$
87,000 
21,500 
9,800 
400 
118,700 
We  believe  the  amount  of  purchased  intangible  assets  recorded  above  represent  the  fair  values  and  approximate  the  amount  a  market  participant
would pay for these intangible assets as of the acquisition date.
Existing technology represents the estimated fair value of exocad’s core technology that has reached technological feasibility. We valued the existing
technology using the multi-period excess earnings method under the income approach. The economic useful life of existing technology was determined by
considering the life cycle of the technology and related cash flows.
Customer relationships represent the fair value of future projected revenue that will be derived from sales of products to existing customers. Customer
relationships were valued using the with-and-without method under the income approach. The economic useful life for customer relationships was based on
historical customer attrition rates.
Tradenames  relates  to  the  exocad  tradenames  that  are  recognized  within  the  industry.  The  fair  value  was  determined  using  the  relief-from-royalty
method under the income approach. The economic useful life of tradenames was determined by benchmarking against similar transactions entered into by
peer companies.
IPR&D refers to the fair value of projects that are not yet completed but have potential value to the company.
77
Note 6. Goodwill and Intangible Assets
During  the  year  ended  December  31,  2021,  we  completed  an  immaterial  business  combination  which  increased  goodwill  and  existing  technology
intangible assets.
Goodwill
The change in the carrying value of goodwill for the year ended December 31, 2021 and 2020, categorized by reportable segments, is as follows (in
thousands):
Balance as of December 31, 2019
Additions from acquisition
Foreign currency translation adjustments
Balance as of December 31, 2020
Additions from acquisition
Foreign currency translation adjustments
Balance as of December 31, 2021
Clear Aligner
Systems and Services
Total
$
$
63,924  $
43,500 
5,267 
112,691 
3,646 
(4,129)
112,208  $
—  $
296,681 
35,445 
332,126 
— 
(25,787)
306,339  $
63,924 
340,181 
40,712 
444,817 
3,646 
(29,916)
418,547 
We completed our annual goodwill impairment assessments in 2021 and 2020 and determined there were no impairments.
Intangible Long-Lived Assets
Acquired intangible long-lived assets were as follows, excluding intangibles that were fully amortized (in thousands):
Existing technology
Customer relationships
Trademarks and tradenames
Patents and other
Foreign currency translation
Total intangible assets
Existing technology
Customer relationships
Trademarks and tradenames
Patents and other
Foreign currency translation
Total intangible assets
Weighted Average
Amortization Period (in
years)
10
11
10
8
Weighted Average
Amortization Period (in
years)
10
11
10
8
Gross Carrying Amount
as of
December 31, 2021
Accumulated
Amortization
Accumulated
Impairment Loss
Net Carrying
Value as of
December 31, 2021
$
$
$
$
104,531  $
55,000 
17,200 
6,511 
183,242  $
(22,495) $
(25,891)
(4,547)
(4,495)
(57,428) $
(4,328) $
(10,751)
(4,179)
— 
(19,258)
$
77,708 
18,358 
8,474 
2,016 
106,556 
3,153 
109,709 
Gross Carrying
Amount as of
December 31, 2020
Accumulated
Amortization
Accumulated
Impairment Loss
Net Carrying
Value as of
December 31, 2020
99,400  $
55,000 
16,600 
6,610 
177,610  $
(12,719) $
(21,879)
(2,934)
(3,785)
(41,317) $
(4,328) $
(10,751)
(4,179)
— 
(19,258)
$
82,353 
22,370 
9,487 
2,825 
117,035 
13,037 
130,072 
There were no triggering events in 2021 or 2020 that would cause impairments of our intangible long-lived assets.
78
The total estimated annual future amortization expense for these acquired intangible assets as of December 31, 2021 is as follows (in thousands):
Amortization
$
$
15,692 
14,997 
13,831 
13,455 
12,849 
35,732 
106,556 
Fiscal Year
2022
2023
2024
2025
2026
Thereafter
Total
Amortization expense was $16.6 million, $13.4 million and $5.9 million for the year ended December 31, 2021, 2020 and 2019, respectively.
Note 7. Equity Method Investments
On July 25, 2016, we acquired a 17% equity interest, on a fully diluted basis, in SmileDirectClub, LLC (“SDC”) for $46.7 million. Concurrently with
the investment, we also entered into a supply agreement to manufacture clear aligners for SDC, which expired on December 31, 2019. The sale of aligners
to SDC and the income from the supply agreement were reported in our Clear Aligner business segment. On July 24, 2017, we purchased an additional 2%
equity  interest  in  SDC  for  $12.8  million.  The  investment  was  accounted  for  as  an  equity  method  investment  and  recorded  in  our  Consolidated  Balance
Sheet.  We  recorded  our  proportional  share  of  SDC’s  losses  within  equity  in  losses  of  investee,  net  of  tax,  in  our  Consolidated  Statement  of  Operations
within our Clear Aligner reportable segment.
As a result of the arbitrator’s decision regarding SDC announced on March 5, 2019, we were ordered to tender our SDC equity interest by April 3,
2019 for a purchase price equal to the “capital account” balance as of October 31, 2017 under the terms of the investment. In April 2019, based on the
“capital account” value provided by SDC, we entered into an unsecured promissory note with SDC to receive $54.2 million through February 1, 2021 in
exchange for the tender of our membership interests. As a result, we derecognized the equity method investment balance of $38.4 million in exchange for
an  unsecured  promissory  note  of  $54.2  million  and  we  recorded  the  difference  of  $15.8  million  as  a  gain  in  2019  in  other  income  in  our  Consolidated
Statement of Operations. The unsecured promissory note was paid in full by SDC during the year ended December 31, 2021.
Although we tendered our membership interests pursuant to the arbitrator’s decision, the parties did not agree on the amount of the “capital account”
balance as of October 31, 2017 or the appropriate repurchase price for the membership units. On July 3, 2019, we filed a demand for arbitration regarding
SDC’s calculation of the “capital account” balance. On March 12, 2021, the Arbitrator ruled in favor of Align and against SDC and issued an award of
$43.4 million along with interest. The gain of $43.4 million was recognized as a part of our other income (expense), net in our Consolidated Statement of
Operation during the year ended December 31, 2021. Refer to Note 10 “Legal Proceedings” of the Notes to Consolidated Financial Statements included for
more information on the arbitration.
Note 8. Credit Facility
On July 21, 2020 we entered into a credit facility for a $300.0 million unsecured revolving line of credit, with a $50.0 million letter of credit sublimit,
and  a  maturity  date  of  July  21,  2023  (“2020  Credit  Facility”).  The  2020  Credit  Facility  requires  us  to  comply  with  specific  financial  conditions  and
performance requirements. Loans under the 2020 Credit Facility bear interest, at our option, at either a rate based on the reserve adjusted LIBOR for the
applicable interest period or a base rate, in each case plus a margin. The base rate is the highest of the credit facility’s publicly announced prime rate, the
federal funds rate plus 0.50% and one-month LIBOR plus 1.0%. The margin ranges from 1.50% to 2.25% for LIBOR loans and 0.50% to 1.25% for base
rate loans. The 2020 Credit Facility allows for an alternative rate to be identified if LIBOR is no longer available. Interest on the loans is payable quarterly
in arrears with respect to base rate loans and at the end of an interest period (and at three month intervals if the interest period exceeds three months) in the
case of LIBOR loans. The outstanding principal, together with accrued and unpaid interest, is due on the maturity date. As of December 31, 2021, we had
no outstanding borrowings under the 2020 Credit Facility and were in compliance with the conditions and performance requirements.
79
Note 9. Impairments and Other Charges (Gains), net
On March 5, 2019, we announced the outcome of the arbitration regarding SDC (Refer to Note 10 “Legal Proceedings” of the Notes to Consolidated
Financial Statements for SDC legal proceedings discussion) which required Align to close its Invisalign stores and tender Align’s equity interest in SDC by
April  3,  2019.  Accordingly,  Align  evaluated  the  ongoing  value  of  the  Invisalign  stores’  operating  lease  right-of-use  assets  and  related  leasehold
improvements and other fixed assets and determined that the carrying value of these assets were not recoverable. Align evaluated the fair value of these
assets and we considered the market participant’s ability to generate economic benefits by using these assets in its highest and best use or by selling it to
another market participant that would use the asset in its highest and best use. As a result, in 2019, we recorded impairment losses of $14.2 million for
operating  lease  right-of-use  assets  and  $14.3  million  of  leasehold  improvements  and  other  fixed  assets.  In  addition,  we  also  recorded  $1.3  million  of
employee  severance  costs  and  other  charges.  During  2019,  we  also  negotiated  early  termination  of  our  Invisalign  store  leases  and  recorded  lease
termination gains of $6.8 million.
Note 10. Legal Proceedings
2018 Securities Class Action Lawsuit
On November 5, 2018, a class action lawsuit against Align and three of our executive officers was filed in the U.S. District Court for the Northern
District of California on behalf of a purported class of purchasers of our common stock. The complaint generally alleged claims under the federal securities
laws and sought monetary damages in an unspecified amount and costs and expenses incurred in the litigation. On December 12, 2018, a similar lawsuit
was filed in the same court on behalf of a purported class of purchasers of our common stock. On November 29, 2019, the lead plaintiff filed an amended
consolidated complaint against Align and two of our executive officers alleging similar claims as the initial complaints on behalf of a purported class of
purchasers  of  our  common  stock  from  May  23,  2018  and  October  24,  2018.  On  September  9,  2020,  Defendants’  motion  to  dismiss  the  amended
consolidated complaint was granted in part and denied in part. On June 30, 2021, counsel for the parties signed a Stipulation and Agreement of Settlement
to resolve all claims for $16 million. The settlement amount will be funded by insurance proceeds and consequently, we recorded a short term liability and
a receivable for this amount in our consolidated financial statements. The Court granted preliminary approval of the settlement on November 2, 2021. A
final settlement approval hearing is currently set for April 28, 2022. The settlement is subject to notice to class members and final approval by the Court.
2019 Shareholder Derivative Lawsuit
In January 2019, three derivative lawsuits were filed in the U.S. District Court for the Northern District of California which were later consolidated,
purportedly on behalf of Align, naming as defendants the then current members of our Board of Directors along with certain of our executive officers. The
allegations in the complaints are similar to those asserted in the 2018 Securities Class Action Lawsuit, but the complaints assert various state law causes of
action, including for breaches of fiduciary duty, insider trading, and unjust enrichment. The complaints seek unspecified monetary damages on behalf of
Align, which is named solely as a nominal defendant against whom no recovery is sought, as well as disgorgement and the costs and expenses associated
with the litigation, including attorneys’ fees. The consolidated action has been stayed pending final disposition of the 2018 Securities Class Action Lawsuit.
On April 12, 2019, a derivative lawsuit was also filed in California Superior Court for Santa Clara County, purportedly on behalf of Align, naming as
defendants the members of our Board of Directors along with certain of our executive officers. The allegations in the complaint are similar to those in the
derivative suits described above. The matter has been similarly stayed pending final disposition of the 2018 Securities Class Action Lawsuit.
Align believes these claims are without merit. Align is currently unable to predict the outcome of these lawsuits and therefore cannot determine the
likelihood of loss nor estimate a range of possible loss.
2020 Securities Class Action Lawsuit
On March 2, 2020, a class action lawsuit against Align and two of our executive officers was filed in the U.S. District Court for the Southern District
of New York (later transferred to the U.S. District Court for the Northern District of California) on behalf of a purported class of purchasers of our common
stock.  The  complaint  alleged  claims  under  the  federal  securities  laws  and  sought  monetary  damages  in  an  unspecified  amount  and  costs  and  expenses
incurred in the litigation. The lead plaintiff filed an amended complaint on August 4, 2020 against Align and three of our executive officers alleging similar
claims as in the initial complaint on behalf of a purported class of purchasers of our common stock from April 25, 2019 to July 24, 2019. On March 29,
2021, defendants’ motion to dismiss the amended complaint was granted with leave for the lead plaintiff to file a further amended complaint. On April 22,
2021, lead plaintiff filed a notice stating it would not file a further amended
80
    
complaint. On April 23, 2021, the Court dismissed the action with prejudice and judgment was entered. Lead plaintiff filed a notice of appeal on April 28,
2021 and filed its opening appeal brief with the United States Court of Appeals for the Ninth Circuit on September 1, 2021. The defendants-appellees filed
their answering brief on November 22, 2021. The lead plaintiff-appellant’s reply brief was filed on January 12, 2022, and oral argument is set for March 10,
2022. Align believes these claims are without merit and intends to vigorously defend itself. Align is currently unable to predict the outcome of this lawsuit
and therefore cannot determine the likelihood of loss nor estimate a range of possible loss.
2020 Shareholder Derivative Lawsuit
On  May  4,  2020,  a  derivative  lawsuit  was  filed  in  the  U.S.  District  Court  for  the  Northern  District  of  California,  purportedly  on  behalf  of  Align,
naming as defendants the members of our Board of Directors along with certain of our executive officers. The allegations in the complaint are similar to
those presented in the 2020 Securities Class Action Lawsuit, but this complaint asserts state law claims for breach of fiduciary duty and insider trading. The
complaint seeks unspecified monetary damages on behalf of Align, which is named solely as a nominal defendant against whom no recovery is sought, as
well as disgorgement and the costs and expenses associated with the litigation, including attorneys’ fees. This action is stayed pending resolution of the
appeal in the 2020 Securities Class Action Lawsuit. Align believes these claims are without merit. Align is currently unable to predict the outcome of this
lawsuit and therefore cannot determine the likelihood of loss nor estimate a range of possible loss.
3Shape Litigation
On February 7, 2022, Align and 3Shape, a Danish corporation, settled their outstanding patent infringement and antitrust litigation, which began in
November 2017. The terms of the settlement are confidential, and the settlement is not expected to have a material effect on Align’s ongoing operations and
financial results. The parties have filed stipulations to stay all proceedings pending completion of the settlement.
Antitrust Class Actions
On June 5, 2020, a dental practice named Simon and Simon, PC doing business as City Smiles brought an antitrust action in the U.S. District Court
for the Northern District of California on behalf of itself and a putative class of similarly situated practices seeking monetary damages and injunctive relief
relating  to  Align’s  alleged  market  activities  in  alleged  clear  aligner  and  intraoral  scanner  markets.  Plaintiff  filed  an  amended  complaint  and  added  VIP
Dental Spas as a plaintiff on August 14, 2020. A jury trial is scheduled to begin in this matter on November 20, 2023. Align believes the plaintiffs’ claims
are without merit and intends to vigorously defend itself.
On May 3, 2021, an individual named Misty Snow brought an antitrust action in the U.S. District Court for the Northern District of California on
behalf of herself and a putative class of similarly situated individuals seeking monetary damages and injunctive relief relating to Align’s alleged market
activities in alleged clear aligner and intraoral scanner markets. Plaintiff filed an amended complaint on July 30, 2021 adding new plaintiffs and various
state law claims. Align moved to dismiss the first amended complaint. On September 30, 2021, the Court dismissed the complaint and granted Plaintiffs
leave to amend. Plaintiffs filed a second amended complaint on October 21, 2021. Align filed a motion to dismiss the second amended complaint, which
the Court granted in part and denied in part. Align believes the plaintiffs’ claims are without merit and intends to vigorously defend itself.
Align is currently unable to predict the outcome of these lawsuits and therefore cannot determine the likelihood of loss, if any, nor estimate a range of
possible loss.
SDC Dispute
In April 2018, SDC Financial LLC, SmileDirectClub LLC, and the Members of SDC Financial LLC other than the Company (collectively, the “SDC
Entities”) initiated confidential arbitration proceedings against Align. In an award dated March 4, 2019, (“Award”) an arbitrator found that Align breached
a restrictive covenant and that Align misused the SDC Entities’ confidential information and violated fiduciary duties to SDC Financial LLC. As part of the
Award,  Align  was  enjoined  from  opening  new  Invisalign  stores  or  providing  certain  services  in  physical  retail  establishments  in  connection  with  the
marketing and sale of clear aligners in the U.S., and enjoined from using the SDC Entities’ confidential information. The arbitrator extended the expiration
date of specified aspects of the restrictive covenant to August 18, 2022. The arbitrator also ordered Align to tender its SDC Financial LLC membership
interests to the SDC Entities for a purchase price equal to the “capital account” balance as of October 31, 2017, to be determined in accordance with the
applicable provisions of the SDC Operating Agreements. No financial damages were awarded to the SDC Entities. The Circuit Court for Cook County,
Illinois confirmed the Award on April 29, 2019.
81
As required by the Award, Align tendered its membership interests for a purchase price that SDC claimed to be Align’s “capital account” balance.
Align disputed that the SDC Entities properly determined the value of Align’s “capital account” balance as of October 31, 2017. Consequently, on July 3,
2019, Align filed a confidential demand for arbitration challenging the propriety of the SDC Entities’ determination. On March 12, 2021 the Arbitrator
issued a final award in favor of Align and against SDC finding that the SDC entities owed Align an additional $43.4 million plus interest. SDC paid the
amount due to Align on March 17, 2021.
On August 27, 2020, Align initiated a confidential arbitration proceeding against the SDC entities before the American Arbitration Association in San
Jose, California. This arbitration relates to the Strategic Supply Agreement (“Supply Agreement”) entered into between the parties in 2016. The complaint
alleges that the SDC Entities breached the Supply Agreement’s terms, causing damages to Align in an amount to be determined. On January 19, 2021, SDC
filed a counterclaim alleging that Align breached the Supply Agreement. Align denies the SDC Entities’ allegations in the counterclaim and will vigorously
defend itself against them. This arbitration hearing is set for July 18-29, 2022.
Align is currently unable to predict the outcome of these disputes and therefore cannot determine the likelihood of loss or success nor estimate a range
of possible loss or success, if any.
In addition to the above, in the ordinary course of Align’s operations, Align is involved in a variety of claims, suits, investigations, and proceedings,
including actions with respect to intellectual property claims, patent infringement claims, government investigations, labor and employment claims, breach
of  contract  claims,  tax,  and  other  matters.  Regardless  of  the  outcome,  these  proceedings  can  have  an  adverse  impact  on  us  because  of  defense  costs,
diversion of management resources, and other factors. Although the results of complex legal proceedings are difficult to predict and Align’s view of these
matters may change in the future as litigation and events related thereto unfold; Align currently does not believe that these matters, individually or in the
aggregate, will materially affect Align’s financial position, results of operations or cash flows.
Note 11. Commitments and Contingencies
Unconditional Purchase Obligations
On May 29, 2018, we entered into a purchase agreement, as amended, with an existing single source supplier which requires us to purchase aligner
material  for  a  minimum  amount  of  approximately  $425.9  million  over  five  years  through  2022.  On  June  24,  2021,  we  amended  the  agreement  which
requires  an  additional  minimum  align  material  purchase  of  approximately  $348.0  million  from  2023  through  2026.  As  of  December  31,  2021,  our
remaining commitment under this agreement totaled $419.6 million.
On  October  30,  2020,  we  entered  into  a  subscription  agreement  with  a  software  company  to  renew  our  license  for  a  total  consideration  of
$95.2 million. As of December 31, 2021, we had a remaining commitment of $47.6 million which is expected to be paid through 2024.
On December 6, 2020, we entered into a supply agreement for certain components used for our manufacturing operations. As of December 31, 2021,
we had purchase commitments of $140.5 million which is expected to be paid through 2025.
On December 14, 2021, we entered into a letter of intent to amend a promotional rights agreement with a third-party which includes advertising and
media coverage. As of December 31, 2021, we had a remaining commitment of $79.2 million which is expected to be paid through 2026.
Off-Balance Sheet Arrangements
As of December 31, 2021, we had no material off-balance sheet arrangements that have, or are reasonably likely to have, a current or future material
effect on our consolidated financial condition, results of operations, liquidity, capital expenditures or capital resources other than certain items disclosed in
the Unconditional Purchase Obligations section above.
Indemnification Provisions
In the normal course of business to facilitate transactions in our services and products, we indemnify certain parties: customers, vendors, lessors, and
other parties with respect to certain matters, including, but not limited to, services to be provided by us and intellectual property infringement claims made
by third parties. In addition, we have entered into indemnification agreements with our directors and our executive officers that will require us, among other
things, to indemnify
82
them against certain liabilities that may arise by reason of their status or service as directors or officers. Several of these agreements limit the time within
which an indemnification claim can be made and the amount of the claim.
It is not possible to make a reasonable estimate of the maximum potential amount under these indemnification agreements due to the unique facts and
circumstances involved in each particular agreement. Additionally, we have a limited history of prior indemnification claims and the payments we have
made under such agreements have not had a material adverse effect on our results of operations, cash flows or financial position. However, to the extent
that valid indemnification claims arise in the future, future payments by us could be significant and could have a material adverse effect on our results of
operations  or  cash  flows  in  a  particular  period.  As  of  December  31,  2021,  we  did  not  have  any  material  indemnification  claims  that  were  probable  or
reasonably possible.
Note 12. Stockholders’ Equity
Common Stock
The  holders  of  common  stock  are  entitled  to  receive  dividends  whenever  funds  are  legally  available  and  when  and  if  declared  by  the  Board  of
Directors. We have never declared or paid dividends on our common stock.
Stock-Based Compensation Plans
Our  2005  Incentive  Plan,  as  amended,  provides  for  the  granting  of  incentive  stock  options,  non-statutory  stock  options,  restricted  stock  units
(“RSUs”), market-performance based restricted stock units (“MSUs”), stock appreciation rights, performance units and performance shares to employees,
non-employee directors and consultants. Shares granted on or after May 16, 2013 as an award of restricted stock, restricted stock unit, market-performance
based restricted stock units, performance share or performance unit (“full value awards”) are counted against the authorized share reserve as one and nine-
tenths (1 9/10) shares for every one (1) share subject to the award, and any shares canceled that were counted as one and nine-tenths against the plan reserve
will be returned at the same ratio. 
As of December 31, 2021, the 2005 Incentive Plan, as amended, has a total reserve of 27,783,379 shares for issuance of which 4,244,723 shares are
available for issuance. We issue new shares from our pool of authorized but unissued shares to satisfy the exercise and vesting obligations of our stock-
based compensation plans.
Summary of Stock-Based Compensation Expense
The stock-based compensation related to our stock-based awards and employee stock purchase plan for the year ended December 31, 2021, 2020 and
2019 is as follows (in thousands):
Cost of net revenues
Selling, general and administrative
Research and development
Total stock-based compensation
2021
Year Ended December 31,
2020
2019
$
$
5,633  $
90,659 
18,044 
114,336  $
4,719  $
78,500 
15,208 
98,427  $
5,154 
69,817 
13,213 
88,184 
The income tax benefit related to stock-based compensation was $13.8 million, $11.9 million and $10.3 million for the year ended December 31,
2021, 2020 and 2019, respectively.
83
 
 
 
Restricted Stock Units
The fair value of RSUs is based on our closing stock price on the date of grant. RSUs granted generally vest over a period of four years. A summary
for the year ended December 31, 2021 is as follows:
Unvested as of December 31, 2020
Granted
Vested and released
Forfeited
Unvested as of December 31, 2021
Weighted Average
Remaining
Contractual Term
(in years)
Aggregate
Intrinsic Value
(in thousands)
Number of Shares
Underlying RSUs
(in thousands)
Weighted Average
Grant Date Fair Value
243.55 
600.10 
216.73 
350.75 
632  $
166 
(265)
(41)
492  $
369.17 
1.1 $
323,239 
The aggregate intrinsic value in the table above represents the total pre-tax intrinsic value (calculated by multiplying our closing stock price on the
last trading day of 2021 by the number of unvested RSUs) that would have been received by the unit holders had all RSUs been vested and released as of
the last trading day of 2021. This amount will fluctuate based on the fair market value of our stock. During 2021, of the 264,655 shares vested and released,
78,930 shares were withheld for employee statutory tax obligations, resulting in a net issuance of 185,725 shares.
The total fair value of RSUs vested as of their respective vesting dates during 2021, 2020 and 2019 was $158.8 million, $89.6 million and $112.4
million,  respectively.  The  weighted  average  grant  date  fair  value  of  RSUs  granted  during  2021,  2020  and  2019  was  $600.10,  $267.24  and  $255.42,
respectively. As of December 31, 2021, we expect to recognize $116.8 million of total unamortized compensation costs, net of estimated forfeitures, related
to RSUs over a weighted average period of 2.1 years.
Market-Performance Based Restricted Stock Units
We grant MSUs to our executive officers. Each MSU represents the right to one share of Align’s common stock. The actual number of MSUs which
will be eligible to vest will be based on the performance of Align’s stock price relative to the performance of a stock market index over the vesting period.
MSUs vest over a period of three years and the maximum number of eligible to vest in the future is 250% of the MSUs initially granted.
The following table summarizes the MSU performance for the year ended December 31, 2021:
Unvested as of December 31, 2020
1
Granted 
Vested and released
Unvested as of December 31, 2021
Weighted Average
Remaining
Contractual Term
(in years)
Aggregate
Intrinsic Value
(in thousands)
Number of Shares
Underlying MSUs
(in thousands)
Weighted Average
Grant Date Fair Value
430.50 
658.02 
513.73 
227  $
177 
(230)
174  $
551.57 
1.0 $
114,414 
1 
  Includes MSUs vested during the period above 100% of the grant as actual shares released is based on Align’s stock performance over the vesting period
The aggregate intrinsic value in the table above represents the total pre-tax intrinsic value (calculated by multiplying our closing stock price on the
last trading day of 2021 by the number of unvested MSUs) that would have been received by the unit holders had all MSUs been vested and released as of
the last trading day of 2021. This amount will fluctuate based on the fair market value of our stock. During 2021, of the 229,877 shares vested and released,
104,317 shares were withheld for employee statutory tax obligations, resulting in a net issuance of 125,560 shares.
The total fair value of MSUs vested as of their respective vesting dates during 2021, 2020 and 2019 was $135.6 million, $47.1 million and $47.7
million, respectively. As of December 31, 2021, we expect to recognize $38.5 million of total unamortized compensation costs, net of estimated forfeitures,
related to MSUs over a weighted average period of 1.0 year.
84
The  fair  value  of  MSUs  is  estimated  at  the  grant  date  using  a  Monte  Carlo  simulation  that  includes  factors  for  market  conditions.  The  weighted
average assumptions used in the Monte Carlo simulation were as follows: 
Expected term (in years)
Expected volatility
Risk-free interest rate
Expected dividends
Weighted average fair value per share at grant date
Employee Stock Purchase Plan (“ESPP”)
2021
Year Ended December 31,
2020
2019
3.0
56.3 %
0.2 %
— 
1,102.09 
$
$
3.0
44.4 %
1.4 %
— 
392.67 
$
3.0
37.3 %
2.5 %
— 
392.03 
In  May  2010,  our  stockholders  approved  the  2010  Employee  Stock  Purchase  Plan  (the  “2010  Purchase  Plan”)  which  consists  of  consecutive
overlapping twenty-four month offering periods with four six-month purchase periods in each offering period. Employees purchase shares at 85% of the
lower of the fair market value of the common stock at either the beginning of the offering period or the end of the purchase period. The 2010 Purchase Plan
will continue until terminated by either the Board of Directors or its administrator. In June 2019, the 2010 Purchase Plan was amended to include a non-
Code Section 423 component to grant purchase rights to employees outside the U.S. and Canada with six-month offering periods and purchase periods. In
May 2021, the 2010 Purchase Plan was amended and restated to increase the maximum number of shares available for purchase to 4,400,000 shares.
The following table summarizes the ESPP shares issued:
Number of shares issued (in thousands)
Weighted average price
2021
Year Ended December 31,
2020
$
131 
195.44  $
116 
175.69  $
2019
130 
136.73 
As of December 31, 2021, 2,194,566 shares remain available for future issuance.
The  fair  value  of  the  option  component  of  the  2010  Purchase  Plan  shares  was  estimated  at  the  grant  date  using  the  Black-Scholes  option  pricing
model with the following weighted average assumptions:
Expected term (in years)
Expected volatility
Risk-free interest rate
Expected dividends
Weighted average fair value at grant date
Year Ended December 31,
2021
2020
2019
1.1
52.7 %
0.1 %
— 
246.84 
$
$
1.0
55.0 %
0.9 %
— 
96.94 
$
1.4
50.0 %
2.2 %
— 
86.02 
We recognized stock-based compensation related to our employee stock purchase plan of $12.2 million, $10.5 million and $12.1 million for the year
ended  December  31,  2021,  2020  and  2019,  respectively.  As  of  December  31,  2021,  we  expect  to  recognize  $10.4  million  of  total  unamortized
compensation costs related to future employee stock purchases over a weighted average period of 0.5 year.
Note 13. Common Stock Repurchase Programs
In May 2018, our Board of Directors authorized a plan to repurchase up to $600.0 million of our common stock (“May 2018 Repurchase Program”).
As of December 31, 2021, the authorization under the May 2018 Repurchase Program was completed. In May 2021, our Board of Directors authorized a
plan to repurchase up to $1.0 billion of our common stock (“May 2021 Repurchase Program”). As of December 31, 2021, we have $725.0 million available
for repurchase under the May 2021 Repurchase Program.
85
 
 
 
  
Accelerated Stock Repurchase Agreements (“ASRs”)
We entered into the following ASRs providing for the repurchase of our common stock based on the volume-weighted average price during the term
of the agreement, less an agreed upon discount. The following table summarizes the information regarding repurchases of our common stock under ASRs:
Agreement
 Date
Q3 2019
Q2 2021
Q2 2021
Q3 2021
Q4 2021
Repurchase
 Program
May 2018
May 2018
May 2021
May 2021
May 2021
$
$
$
$
$
Amount Paid 
(in millions)
200.0 
100.0 
100.0 
75.0 
100.0 
Completion
Date
Q3 2019
Q3 2021
Q3 2021
Q3 2021
Q4 2021
Total Shares
Received
Average Price per
Share
1,132,464  $
171,322  $
161,707  $
109,239  $
150,031  $
176.61 
583.70 
618.40 
686.91 
666.53 
Open Market Common Stock Repurchases
During the year ended December 31, 2019, we repurchased on the open market approximately 0.8 million shares of our common stock at an average
price of $264.93 per share, including commissions, for an aggregate purchase price of $200.0 million.
Subsequent  to  year  end,  during  February  2022,  we  repurchased  on  the  open  market  approximately  0.1  million  shares  of  our  common  stock  at  an
average price of $522.35 per share, including commissions, for an aggregate purchase price of $75.0 million.
Note 14. Employee Benefit Plans
We have defined contribution retirement plan under Section 401(k) of the Internal Revenue Code for our U.S. employees which covers substantially
all U.S. employees who meet minimum age and service requirements and allows participants to defer a portion of their annual compensation on a pre-tax
basis. We match 50% of our employee’s salary deferral contributions up to 6% of the employee’s eligible compensation. We contributed approximately
$8.5 million, $6.9 million and $6.2 million to the 401(k) plan during the year ended December 31, 2021, 2020 and 2019, respectively. We also have defined
contribution  retirement  plans  outside  of  the  U.S.  to  which  we  contributed  $42.3  million,  $28.9  million  and  $25.4  million  during  the  year  ended
December 31, 2021, 2020 and 2019, respectively.
Note 15. Income Taxes
Net income before provision for (benefit from) income taxes and equity in losses of investee consists of the following (in thousands):
Domestic
Foreign
Net income before provision for (benefit from) income taxes and equity in losses of
investee
$
$
2021
Year Ended December 31,
2020
2019
378,478  $
633,945 
173,099  $
205,850 
1,012,423  $
378,949  $
184,956 
377,695 
562,651 
86
 
 
The provision for (benefit from) income taxes consists of the following (in thousands):
Federal
Current
Deferred
State
Current
Deferred
Foreign
Current
Deferred
Provision for (benefit from) income taxes
2021
Year Ended December 31,
2020
2019
$
$
157,383  $
(25,598)
131,785 
28,365 
(5,860)
22,505 
42,681 
43,432 
86,113 
240,403  $
55,291  $
(11,749)
43,542 
8,862 
(2,121)
6,741 
29,399 
(1,476,621)
(1,447,222)
(1,396,939) $
76,528 
1,235 
77,763 
9,169 
209 
9,378 
28,364 
(3,158)
25,206 
112,347 
The differences between income taxes using the federal statutory income tax rate for 2021, 2020 and 2019 and our effective tax rates are as follows: 
U.S. federal statutory income tax rate
State income taxes, net of federal tax benefit
U.S. tax on foreign earnings
Impact of differences in foreign tax rates
Stock-based compensation
Impact of expiration of statute of limitations
Impact of intra-entity intellectual property rights transfer
Settlement on audits
Impact of U.S. Tax Cuts and Jobs Act
Change in valuation allowance
Other items not individually material
Effective tax rate
Year Ended December 31,
2021
2020
2019
21.0 %
2.2 
2.7 
(2.0)
(0.3)
(0.7)
— 
— 
— 
1.1 
(0.3)
23.7 %
21.0 %
1.8 
— 
5.6 
1.1 
(0.3)
(395.6)
(1.4)
(0.5)
0.1 
(0.4)
(368.6)%
21.0 %
1.7 
1.9 
(5.1)
(0.3)
— 
— 
— 
— 
0.1 
0.7 
20.0 %
As of December 31, 2021, substantially all of the earnings previously determined to be not indefinitely reinvested have been repatriated. U.S. income
taxes have already been provided on the $1,257.5 million undistributed earnings that is indefinitely reinvested in our international operations, therefore, the
tax impact upon distribution is limited to mainly state income and withholding taxes and is not significant.
During the year ended December 31, 2020, we completed an intra-entity transfer of certain intellectual property rights and fixed assets to our new
Swiss subsidiary, where our EMEA regional headquarters is located beginning January 1, 2020. The transfer of intellectual property rights did not result in
a taxable gain; however, it did result in a step-up of the Swiss tax deductible basis in the transferred assets, and accordingly, created a temporary difference
between the book basis and the tax basis of such intellectual property rights. Consequently, this transaction resulted in the recognition of a deferred tax
asset and related one-time tax benefit of approximately $1,493.5 million during the year ended December 31, 2020, which is the net impact of the deferred
tax asset recognized as a result of the additional Swiss tax deductible basis in the transferred assets and certain costs related to the transfer of fixed assets
and inventory.
87
 
 
 
 
As of December 31, 2021 and 2020, the significant components of our deferred tax assets and liabilities are (in thousands):
Deferred tax assets:
Net operating loss and capital loss carryforwards
Reserves and accruals
Stock-based compensation
Deferred revenue
Amortizable tax basis in intangibles
Net translation losses
Credit carryforwards
Total deferred tax assets
Deferred tax liabilities:
Depreciation and amortization
Acquisition-related intangibles
Prepaid expenses
Total deferred tax liabilities
Net deferred tax assets before valuation allowance
Valuation allowance
Net deferred tax assets
December 31,
2021
2020
$
$
11,069  $
47,641 
13,576 
83,514 
1,392,471 
10,008 
5,637 
1,563,916 
11,915 
28,989 
6,931 
47,835 
1,516,081 
(12,938)
1,503,143  $
20,728 
34,469 
10,842 
32,562 
1,468,159 
2,939 
905 
1,570,604 
14,730 
35,689 
1,720 
52,139 
1,518,465 
(1,325)
1,517,140 
The available positive evidence at December 31, 2021 included historical operating profits and a projection of future income sufficient to realize most
of our remaining deferred tax assets. As of December 31, 2021, it was considered more likely than not that our deferred tax assets would be realized with
the exception of certain net operating loss, capital loss carryovers and unrealized translation losses as we are unable to forecast sufficient future profits to
realize the deferred tax assets. The total valuation allowance as of December 31, 2021 was $12.9 million. During the year ended December 31, 2021, the
valuation allowance increased by $11.6 million primarily due to deferred tax assets related to unrealized translation losses and net operating loss from one
of our German subsidiaries that are not more likely than not to be realized.
As  of  December  31,  2021,  we  have  foreign  net  operating  loss  carryforwards  of  approximately  $44.8  million,  attributed  mainly  to  losses  in  Israel,
China and Germany. The losses in Israel and Germany can be carried forward indefinitely. The operating loss carryforwards in China, if not utilized, will
expire beginning 2026.
The changes in the balance of gross unrecognized tax benefits, which exclude interest and penalties, for the year ended December 31, 2021, 2020 and
2019, are as follows (in thousands):
Gross unrecognized tax benefits at January 1,
Increases related to tax positions taken during the current year
Increases related to tax positions taken during a prior year
Decreases related to tax positions taken during a prior year
Decreases related to expiration of statute of limitations
Decreases related to settlement with tax authorities
Gross unrecognized tax benefits at December 31,
2021
Year Ended December 31,
2020
2019
$
$
46,320  $
27,710 
5,471 
(5,804)
(8,986)
(1,416)
63,295  $
46,650  $
20,592 
10,201 
(29,977)
— 
(1,146)
46,320  $
33,262 
19,012 
143 
(3,783)
(1,984)
— 
46,650 
The total amount of gross unrecognized tax benefits as of December 31, 2021 was $63.3 million, of which $61.9 million would impact our effective
tax rate if recognized.
We  file  U.S.  federal,  U.S.  state,  and  non-U.S.  income  tax  returns.  Our  major  tax  jurisdictions  include  U.S.  federal,  the  State  of  California  and
Switzerland. For U.S. federal and state tax returns, we are no longer subject to tax examinations for years before 2018 and 2014, respectively. Our Israeli
subsidiary is under tax audit for years 2016 through 2019. During the fourth quarter of 2021, the Israel Tax Authority issued a tax assessment in connection
with a 2016 transaction to which our Israeli subsidiary was a party. We intend to file an administrative appeal during the first quarter of 2022 and will
continue to
88
 
 
vigorously defend our Israeli subsidiary’s tax return position. Based on our assessment of the information currently available, we have not derecognized or
remeasured  our  tax  positions  with  respect  to  this  matter  during  the  year.  With  few  exceptions,  we  are  no  longer  subject  to  examination  by  foreign  tax
authorities for years before 2014.
We  have  elected  to  recognize  interest  and  penalties  related  to  unrecognized  tax  benefits  as  a  component  of  income  taxes.  Interest  and  penalties
included in tax expense for the year ended December 31, 2021, 2020 and 2019 as well as accrued as of December 31, 2021 and 2020 were not material.
While we defend income tax audits in various jurisdictions and the results of such audits may differ materially from the amounts accrued for each year, we
cannot currently ascertain the bases on which any given audit will be ultimately resolved. Accordingly, we are unable to estimate the range of possible
adjustments to our balance of gross unrecognized tax benefits in the next 12 months.
Note 16. Net Income per Share
Basic net income per share is computed using the weighted average number of shares of common stock outstanding during the period. Diluted net
income  per  share  is  computed  using  the  weighted  average  number  of  shares  of  common  stock,  adjusted  for  any  dilutive  effect  of  potential  common
stock. Potential common stock, computed using the treasury stock method, includes RSUs, MSUs and our ESPP.
The following table sets forth the computation of basic and diluted net income per share attributable to common stock (in thousands, except per share
amounts): 
Numerator:
Net income
Denominator:
Weighted average common shares outstanding, basic
Dilutive effect of potential common stock
Total shares, diluted
Net income per share, basic
Net income per share, diluted
$
$
$
2021
Year Ended December 31,
2020
2019
772,020  $
1,775,888  $
442,776 
78,917 
753 
79,670 
9.78  $
9.69  $
78,760 
470 
79,230 
22.55  $
22.41  $
79,424 
676 
80,100 
5.57 
5.53 
79 
Anti-dilutive potential common shares 
1
1 
280 
1
    Represents RSUs and MSUs not included in the calculation of diluted net income per share as the effect would have been anti-dilutive.
89
 
 
Note 17. Supplemental Cash Flow Information
The supplemental cash flow information consists of the following (in thousands): 
Taxes paid
Non-cash investing and financing activities:
Acquisition of property, plant and equipment in accounts payable and
accrued liabilities
Issuance of promissory note in exchange for sale of equity method
investment
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases
(1)
Investing cash flows from finance leases 
Financing cash flows from finance leases
Right-of-use assets obtained in exchange for lease obligations:
Operating leases
Finance leases
$
$
$
$
$
$
$
$
2021
Year Ended December 31,
2020
2019
203,309  $
76,332  $
71,746 
64,135  $
37,267  $
—  $
—  $
29,769  $
—  $
—  $
68,463  $
—  $
26,022  $
—  $
—  $
47,981  $
—  $
16,488 
54,154 
26,337 
10,896 
45,773 
32,723 
51,064 
1
    A portion of finance lease purchase payment relates to leasing a part of the building to a third party as a lessor. This amount is included in Other Investing Activities
in our Consolidated Statement of Cash Flows.
Note 18. Segments and Geographical Information
Segment Information
We report segment information based on the management approach. The management approach designates the internal reporting used by our Chief
Operating  Decision  Maker  for  decision  making  and  performance  assessment  as  the  basis  for  determining  our  reportable  segments.  The  performance
measures of our reportable segments include net revenues, gross profit and income from operations. Income from operations for each segment includes all
geographic revenues, related cost of net revenues and operating expenses directly attributable to the segment. Certain operating expenses are attributable to
operating  segments  and  each  allocation  is  measured  differently  based  on  the  specific  facts  and  circumstances  of  the  costs  being  allocated.  Costs  not
specifically  allocated  to  segment  income  from  operations  include  various  corporate  expenses  such  as  stock-based  compensation  and  costs  related  to  IT,
facilities,  human  resources,  accounting  and  finance,  legal  and  regulatory,  and  other  separately  managed  general  and  administrative  costs  outside  the
operating segments.
We group our operations into two reportable segments: Clear Aligner segment and Systems and Services segment.
• Our Clear Aligner segment consists of Comprehensive Products, Non-Comprehensive Products and Non-Case revenues as defined below:
• Comprehensive Products include, but are not limited to, Invisalign Comprehensive and Invisalign First.
• Non-Comprehensive  Products  include,  but  are  not  limited  to,  Invisalign  Moderate,  Lite  and  Express  packages  and  Invisalign  Go  and
Invisalign Go Plus.
• Non-Case  products  include,  but  are  not  limited  to,  retention  products,  Invisalign  training,  adjusting  tools  used  by  dental  professionals
during  the  course  of  treatment  and  Consumer  Products  that  are  complementary  to  our  doctor-prescribed  principal  products,  such  as
aligner cases (clamshells), teeth whitening products, cleaning solutions (crystals, foam and other material) and other oral health products
available in certain e-commerce channels in the U.S.
• Our Systems and Services segment consists of our iTero intraoral scanning systems, which includes a single hardware platform and restorative or
orthodontic  software  options.  Our  services  include  subscription  software,  disposables,  rentals,  pay  per  scan  services,  as  well  as  exocad’s
CAD/CAM software solutions that integrate workflows to dental labs and dental practices.
90
 
 
 
Summarized financial information by segment is as follows (in thousands):
2021
Year Ended December 31,
2020
2019
Net revenues
Clear Aligner
Systems and Services
Total net revenues
Gross profit
Clear Aligner
Systems and Services
Total gross profit
Income from operations
Clear Aligner
Systems and Services
Unallocated corporate expenses
Total income from operations
Stock-based compensation
Clear Aligner
Systems and Services
Unallocated corporate expenses
Total stock-based compensation
Depreciation and amortization
Clear Aligner
Systems and Services
Unallocated corporate expenses
Total depreciation and amortization
Impairments and other charges (gains), net
Clear Aligner
Total impairments and other charges (gains), net
Litigation settlement gain
Clear Aligner
Total litigation settlement gain
$
$
$
$
$
$
$
$
$
$
$
$
$
$
3,247,080  $
705,504 
3,952,584  $
2,474,373  $
460,982 
2,935,355  $
1,325,866  $
259,127 
(608,593)
976,400  $
10,648  $
705 
102,983 
114,336  $
50,723  $
21,581 
36,425 
108,729  $
—  $
—  $
—  $
—  $
2,101,459  $
370,482 
2,471,941  $
1,532,130  $
231,105 
1,763,235  $
768,045  $
96,052 
(476,926)
387,171  $
8,975  $
734 
88,718 
98,427  $
41,371  $
16,798 
35,369 
93,538  $
—  $
—  $
—  $
—  $
2,025,750 
381,046 
2,406,796 
1,499,713 
244,184 
1,743,897 
835,957 
137,720 
(431,184)
542,493 
9,220 
255 
78,709 
88,184 
38,979 
7,441 
32,570 
78,990 
22,990 
22,990 
(51,000)
(51,000)
The following table reconciles total segment income from operations in the table above to net income before provision for (benefit from) income
taxes and equity in losses of investee (in thousands):
Total segment income from operations
Unallocated corporate expenses
Total income from operations
Interest income
Other income (expense), net
Net income before provision for (benefit from) income taxes and equity in
losses of investee
$
$
91
2021
Year Ended December 31,
2020
2019
1,584,993  $
(608,593)
976,400 
3,103 
32,920 
864,097  $
(476,926)
387,171 
3,125 
(11,347)
1,012,423  $
378,949  $
973,677 
(431,184)
542,493 
12,482 
7,676 
562,651 
 
 
Geographical Information
Net revenues are presented below by geographic area (in thousands): 
Net revenues :
 1
U.S.
2
Switzerland 
China
2
The Netherlands 
Other International
Total net revenues
2021
Year Ended December 31,
2020
2019
$
$
1,724,296  $
1,353,229 
275,503 
— 
599,556 
3,952,584  $
1,099,564  $
809,080 
199,851 
— 
363,446 
2,471,941  $
1,161,959 
— 
196,733 
760,444 
287,660 
2,406,796 
1
    Net revenues are attributed to countries based on the location of where revenues are recognized by our legal entities.
2     
In 2020, we implemented a new international corporate structure. This changed the structure of international procurement and sales operations from the Netherlands
to Switzerland.
Tangible long-lived assets, which includes Property, plant and equipment, net, and Operating lease right-of-use assets, net, are presented below by
geographic area (in thousands):
1
Long-lived assets  :
Switzerland
U.S.
China
Costa Rica
Other International
Total long-lived assets
As of December 31,
2021
2020
$
$
444,205  $
210,582 
125,346 
92,204 
330,846 
1,203,183  $
257,337 
180,539 
113,918 
97,804 
167,676 
817,274 
1
    Long-lived assets are attributed to countries based on the location of our entity that owns or leases the assets.
Item 9. Changes in and Disagreements With Accountants on Accounting and Financial Disclosure.
None
Item 9A. Controls and Procedures.
Evaluation of disclosure controls and procedures.
Under the supervision and with the participation of our management, including our Chief Executive Officer and our Chief Financial Officer, we have
evaluated the effectiveness of the design and operation of our disclosure controls and procedures (as defined in Rules 13a-15(e) and 15d-15(e) under the
Exchange Act). Based upon that evaluation, our Chief Executive Officer and our Chief Financial Officer have concluded that our disclosure controls and
procedures are effective as of December 31, 2021 to provide reasonable assurance that information required to be disclosed by us in the reports that we file
or submit under the Exchange Act is accumulated and communicated to our management, including our Chief Executive Officer and our Chief Financial
Officer, as appropriate, to allow timely decisions regarding required disclosure, and that such information is recorded, processed, summarized and reported
within the time periods specified in the Securities and Exchange Commission rules and forms.
Management's annual report on internal control over financial reporting.
See “Report of Management on Internal Control over Financial Reporting” of this Annual Report on Form 10-K.
Changes in internal control over financial reporting.
There have been no changes in our internal control over financial reporting during the quarter ended December 31, 2021 that have materially affected,
or are reasonably likely to materially affect, our internal control over financial reporting.
92
 
 
 
 
 
Item 9B. Other Information.
None.
Item 9C. Disclosure Regarding Foreign Jurisdictions that Prevent Inspections.
None.
PART III
Certain information required by Part III is omitted from this Form 10-K because we intend to file a definitive Proxy Statement for our 2022 Annual
Meeting of Stockholders (the “Proxy Statement”) not later than 120 days after the end of the fiscal year covered by this Annual Report on Form 10-K, and
certain information to be included therein is incorporated herein by reference.
Item 10. Directors, Executive Officers and Corporate Governance.
The  information  required  by  Item  401  of  Regulation  S-K  concerning  our  directors  is  incorporated  by  reference  to  the  Proxy  Statement  under  the
section captioned “Election of Directors.” The information required by Item 401 of Regulation S-K concerning our executive officers is set forth in Item 1
— “Business” of this Annual Report on Form 10-K. The information required by Item 405 of Regulation S-K is incorporated by reference to the section
entitled  “Delinquent  Section  16(a)  Reports”  contained  in  the  Proxy  Statement. The  information  required  by  Item  407(c)(3),  407(d)(4)  and  407(d)(5)  of
Regulation S-K is incorporated by reference to the Proxy Statement under the section entitled “Corporate Governance”.
Code of Ethics
We have a code of ethics (which we call our Global Code of Conduct) that applies to all of our employees, including our principal executive officer,
principal  financial  officer  and  controller.  Our  Global  Code  of  Conduct  is  posted  on  the  investor  relations  portion  of  our  website  at
http://investor.aligntech.com within the section captioned “Corporate Governance”.
We intend to satisfy the disclosure requirement under Item 5.05 of Form 8-K regarding an amendment to, or waiver from, a provision of this code of
ethics by posting such information on our website, at the address and location specified above, or as otherwise required by the NASDAQ Global Market.
Item 11. Executive Compensation.
The information required by Item 402 of Regulation S-K is incorporated by reference to the Proxy Statement under the section captioned “Executive
Compensation.” The information required by Items 407(e)(4) and (e)(5) is incorporated by reference to the Proxy Statement under the section captioned
“Corporate  Governance  -  Compensation  Committee  Interlocks  and  Insider  Participation”  and  “Compensation  Committee  of  the  Board  Report,”
respectively.
93
Item 12. Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters.
The information required by Item 403 of Regulation S-K is incorporated by reference to the Proxy Statement under the section captioned “Principal
Stockholders”.
Equity Compensation Plan Information
The  following  table  provides  information  as  of  December  31,  2021  about  our  common  stock  that  may  be  issued  upon  the  awards  granted  to
employees,  consultants  or  members  of  our  Board  of  Directors  under  all  existing  equity  compensation  plans,  including  the  2005  Incentive  Plan  and  the
Employee Stock Purchase Plan (“ESPP”), each as amended, and certain individual arrangements (Refer to Note 12 "Stockholders’ Equity” of the Notes to
Consolidated Financial Statements for a description of our equity compensation plans).
Plan Category
Equity compensation plans approved by
security holders
Equity compensation plans not approved
by security holders
Total
Number of securities to be issued
upon exercise of outstanding
options and restricted stock units
(a)
Weighted average
exercise price of
outstanding options (b)
Number of securities remaining available for
future issuance under equity compensation
plans (excluding securities reflected in column
(a))
665,957 
1
— 
665,957 
$
$
— 
— 
— 
6,439,289 
2, 3
— 
6,439,289 
1
    Includes 491,858 RSUs and 174,099 MSUs at target
2
    Includes 2,194,566 shares available for issuance under our ESPP. We are unable to ascertain with specificity the number of securities to be issued upon exercise of
outstanding rights or the weighted average exercise price of outstanding rights under the ESPP.
3
    Includes additional 496,182 of potentially issuable MSUs above target if performance targets are achieved at maximum payout (counted one and nine-tenths (1 9/10)
shares for every one (1) issuable share against the authorized share reserve)
Item 13. Certain Relationships and Related Transactions, and Director Independence.
The  information  required  by  Item  404  and  Item  407  of  Regulation  S-K  is  incorporated  by  reference  to  the  Proxy  Statement  under  the  sections
captioned “Certain Relationships and Related Party Transactions” and “Corporate Governance—Director Independence,” respectively.
Item 14. Principal Accountant Fees and Services.
The  information  required  by  Item  9(e)  of  Schedule  14A  of  the  Securities  Act  of  1934,  as  amended,  is  incorporated  by  reference  to  the  Proxy
Statement under the section captioned “Ratification of Appointment of Independent Registered Public Accountants.”
94
Item 15. Exhibit and Financial Statement Schedules.
(a)
Financial Statements
1.
Consolidated financial statements
PART IV
The following documents are filed as part of this Annual Report on Form 10-K:
Report of Independent Registered Public Accounting Firm
Consolidated Statements of Operations for the year ended December 31, 2021, 2020 and 2019
Consolidated Statements of Comprehensive Income for the year ended December 31, 2021, 2020 and 2019
Consolidated Balance Sheets as of December 31, 2021 and 2020
Consolidated Statements of Stockholders’ Equity for the year ended December 31, 2021, 2020 and 2019
Consolidated Statements of Cash Flows for the year ended December 31, 2021, 2020 and 2019
Notes to Consolidated Financial Statements
56
58
59
60
61
62
63
2.
The following financial statement schedule is filed as part of this Annual Report on Form 10-K:
Schedule II—Valuation and Qualifying Accounts and Reserves for the year ended December 31, 2021, 2020 and 2019
All other schedules have been omitted as they are not required, not applicable, or the required information is otherwise included.
SCHEDULE II: VALUATION AND QUALIFYING ACCOUNTS AND RESERVES
Balance at
Beginning
of Period
Additions
(Reductions)
to Costs and
Expenses
Write
Offs
Balance at
End of Period
Allowance for doubtful accounts:
Year Ended December 31, 2019
Year Ended December 31, 2020
Year Ended December 31, 2021
Valuation allowance for deferred tax assets:
Year Ended December 31, 2019
Year Ended December 31, 2020
Year Ended December 31, 2021
$
$
$
$
$
$
(in thousands)
5,853  $
12,073  $
2,814  $
835  $
239  $
11,613  $
(1,475) $
(8,590) $
(3,808) $
—  $
—  $
—  $
6,756 
10,239 
9,245 
1,086 
1,325 
12,938 
2,378  $
6,756  $
10,239  $
251  $
1,086  $
1,325  $
95
 
 
 
 
 
(b)
The following Exhibits are included in this Annual Report on Form 10-K:
Exhibit
Number
Description
3.1
Amended and Restated Certificate of Incorporation of registrant
3.1A
3.2
3.2A
4.1
4.2
10.1A†
10.2†
10.3†
10.3A†
10.4†
10.5†
10.6†
10.7†
10.8†
10.8A†
10.9†
10.9A†
10.10†
10.11†
10.12†
10.13†
10.14†
10.15†
10.16†
10.17
Certificate of Amendment to the Amended and Restated Certificate of
Incorporation
Amended and Restated Bylaws of registrant
Amendment to Amended and Restated Bylaws of registrant
Form of Specimen Common Stock Certificate
Description of the Capital Stock of registrant
Amended Registrant’s 2010 Employee Stock Purchase Plan
Registrant's 2005 Incentive Plan (as amended May 2016)
Form of RSU agreement under Registrant's 2005 Incentive Plan (Officer Form
for officers appointed after September 2016)
Form of RSU agreement under Registrant's 2005 Incentive Plan (Officer Form
for officers appointed prior to September 2016)
Form of RSU agreement (CEO)
Form of RSU agreement under Registrant's 2005 Incentive Plan (Non-employee
Director Form)
Align 2019 Global RSU Agreement
Form of option award agreement under registrant’s 2005 Incentive Plan
Form of Market Stock Unit Agreement under Registrant's 2005 Incentive Plan
(Officer Form for MSU awards granted in 2018, 2019 and 2020 to officers
appointed after September 2016)
Form of Market Stock Unit Agreement under Registrant's 2005 Incentive Plan
(Officer Form for MSU awards granted in 2018, 2019 and 2020 to officers
appointed prior to September 2016)
Form of Market Stock Unit Agreement under Registrant's 2005 Incentive Plan
(Officer Form for MSU awards granted in 2021 to officers appointed after
September 2016)
Form of Market Stock Unit Agreement under Registrant's 2005 Incentive Plan
(Officer Form for MSU awards granted in 2021 to officers appointed prior to
September 2016)
Form of Market Stock Unit Agreement for CEO (Focal grants)
Form of Market Stock Unit Agreement for CEO Special MSU Award June 2018
Form of Employment Agreement entered into by and between registrant and
each executive officer (other than CEO for executives appointed prior to
September 2016)
Form of Employment Agreement entered into by and between registrant and
each executive officer (other than CEO for executives appointed after
September 2016)
Amended and Restated Chief Executive Officer Employment Agreement
between Align Technology, Inc. and Joseph Hogan
Employment Agreement between registrant and John F. Morici (Chief Financial
Officer)
Form of Indemnification Agreement by and between registrant and its Board of
Directors and its executive officers
Sale and Purchase Agreement between CETP III Ivory S.a.r.l., and Align
Technology, Inc. and its indirect wholly owned German subsidiary, mertus
602.GmbH, dated March 3, 2020
96
Form
S-1, as amended (File
No. 333-49932)
8-K
8-K
Def 14A
S-1, as amended (File
No. 333-49932)
10-K
Def 14A
10-K
10-K
Date
12/28/2000
5/20/2016
2/29/2012
4/7/2021
1/17/2001
2/28/2020
4/7/2021
2/26/2021
2/28/2020
Exhibit
Number
Incorporated
by Reference
herein
3.1
Filed
herewith
3.01
3.2
1.0
4.1
4.2
2.0
10.2
10.3
10-K
10-K
10-K
10-K
10-Q
10-K
10-K
10-K
10-K
10-K
8-K
10-Q
10-K
10-Q
10-Q
S-1 as amended (File
No. 333-49932)
10-Q
2/28/2020
10.3A
2/28/2020
2/28/2020
2/28/2019
8/4/2005
2/28/2020
10.4
10.5
10.6
10.4
10.8
2/28/2020
10.8A
2/26/2021
10.9
2/26/2021
10.9A
2/28/2020
6/25/2018
5/8/2008
2/28/2017
5/1/2015
11/8/2016
1/17/2001
5/5/2020
10.9
10.1
10.3
10.8
10.30
10.2
10.15
10.1
Exhibit
Number
10.18
10.19
21.1
23.1
31.1
31.2
32t
101.INS
Description
Credit Agreement between Align Technology, Inc. and the lenders party thereto
from time to time and Citibank, N.A., as administrative agent, dated July 21,
2020
Fixed Dollar Accelerated Share Repurchase Transaction dated October 29, 2021
Subsidiaries of Align Technology, Inc.
Consent of PricewaterhouseCoopers LLP, Independent Registered Public
Accounting Firm
Certifications of Chief Executive Officer pursuant to Exchange Act Rules 13a-
14(a) and 15d-14(a), as adopted pursuant to Section 302 of the Sarbanes-Oxley
Act of 2003
Certifications of Chief Financial Officer pursuant to Exchange Act Rules 13a-
14(a) and 15d-14(a), as adopted pursuant to Section 302 of the Sarbanes-Oxley
Act of 2003
Certification of Chief Executive Officer and Chief Financial Officer pursuant to
18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-
Oxley Act of 2003
Inline XBRL Instance Document (the instance document does not appear in the
Interactive Data File because its XBRL tags are embedded within the Inline
XBRL document).
101.SCH Inline XBRL Taxonomy Extension Schema Document
101.CAL
101.DEF
101.LAB
101.PRE
104
Inline XBRL Taxonomy Extension Calculation Linkbase Document
Inline XBRL Taxonomy Extension Definition Linkbase Document
Inline XBRL Taxonomy Extension Label Linkbase Document
Inline XBRL Taxonomy Extension Presentation Linkbase Document
Cover Page Interactive Data File (formatted as inline XBRL and contained in
Exhibit 101)
Form
10-Q
Date
10/30/2020
Exhibit
Number
Incorporated
by Reference
herein
10.1
Filed
herewith
*
*
*
*
*
*
*
*
*
*
*
*
*
__________________________________ 
†
t
Management contract or compensatory plan or arrangement filed as an Exhibit to this form pursuant to Items 14(a) and 14(c) of Form 10-K.
Furnished herewith
Item 16. Form 10-K Summary.
Not applicable.
97
Pursuant to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, the Registrant has duly caused this report to be signed on
its behalf by the undersigned, thereunto duly authorized.
SIGNATURES
ALIGN TECHNOLOGY, INC.
By:
Date:
/S/    JOSEPH M. HOGAN        
Joseph M. Hogan
President and Chief Executive Officer
February 25, 2022
Each person whose signature appears below constitutes and appoints Joseph M. Hogan or John F. Morici, his or her attorney-in-fact, with the power
of substitution, for him or her in any and all capacities, to sign any amendments to this Report on Form 10-K and to file the same, with exhibits thereto and
other documents in connection therewith, with the Securities and Exchange Commission, hereby ratifying and confirming all that each of said attorneys-in-
fact, or his or her substitute or substitutes, may do or cause to be done by virtue hereof.
Pursuant to the requirements of the Securities Exchange Act of 1934, this report has been signed below by the following persons on behalf of the
Registrant and in the capacities and on the dates indicated.
Signature
Title
/S/    JOSEPH M. HOGAN
Joseph M. Hogan
/S/    JOHN F. MORICI
John F. Morici
/S/    KEVIN J. DALLAS
Kevin J. Dallas
/S/    JOSEPH LACOB 
Joseph Lacob
/S/    C. RAYMOND LARKIN, JR.     
C. Raymond Larkin, Jr.
/S/    GEORGE J. MORROW    
George J. Morrow
/S/    ANNE M. MYONG      
Anne M. Myong
/S/    ANDREA L. SAIA
Andrea L. Saia
/S/    GREG J. SANTORA
Greg J. Santora
/S/    SUSAN E. SIEGEL 
Susan E. Siegel
/S/ WARREN S. THALER
Warren S. Thaler
President and Chief Executive Officer (Principal
Executive Officer)
Chief Financial Officer and Executive Vice
President, Global Finance (Principal Financial Officer and
Principal Accounting Officer)
Director
Director
Director
Director
Director
Director
Director
Director
Director
98
Date
February 25, 2022
February 25, 2022
February 25, 2022
February 25, 2022
February 25, 2022
February 25, 2022
February 25, 2022
February 25, 2022
February 25, 2022
February 25, 2022
February 25, 2022
 
  
 
  
 
  
 
  
 
  
 
  
 
Citibank, N.A. 
388 Greenwich Street, 4  Floor 
New York, NY 10013 Attention: Equity Derivatives                                                                         Opening Transaction
th
Exhibit 10.19
Align Technology, Inc. 
410 N. Scottsdale Road, Suite 1300 
Tempe, Arizona 85281
________________
Citibank, N.A.
Fixed Dollar Accelerated Share Repurchase Transaction
October 29, 2021
To:
A/C:
From:
Re:
Date:
Dear Sir/Madam:
The purpose of this letter agreement (this “Confirmation”) is to confirm the terms and conditions of the Transaction entered into between Citibank,
N.A.  (“Dealer”)  and  Align  Technology,  Inc.  (“Issuer”)  on  the  Trade  Date  specified  below  (the  “Transaction”).  This  confirmation  constitutes  a
“Confirmation” as referred to in the Agreement specified below.
The  definitions  and  provisions  contained  in  the  2002  ISDA  Equity  Derivatives  Definitions  (as  published  by  the  International  Swaps  and
Derivatives Association, Inc. (“ISDA”)) (the “Equity Definitions”) are incorporated into this Confirmation. The Transaction is a Share Forward Transaction
for  purposes  of  the  Equity  Definitions.  Any  reference  to  a  currency  shall  have  the  meaning  contained  in  Section  1.7  of  the  2006  ISDA  Definitions,  as
published by ISDA.
1.    This Confirmation evidences a complete and binding agreement between Dealer and Issuer as to the terms of the Transaction to which this
Confirmation  relates  and  shall  supersede  all  prior  or  contemporaneous  written  or  oral  communications  with  respect  thereto.  This  Confirmation  shall  be
subject to an agreement (the “Agreement”) in the form of the 2002 ISDA Master Agreement as if Dealer and Issuer had executed an agreement in such
form without any Schedule but with the elections set forth in this Confirmation (and (1) the election of USD as the Termination Currency, (2) the election
that subparagraph (ii) of Section 2(c) will not apply to the Transactions and (3) the election that the “Cross Default” provisions of Section 5(a)(vi) shall
apply to Dealer, with a “Threshold Amount” of 3% of Dealer shareholders’ equity for Dealer (provided that (a) the phrase “or becoming capable at such
time of being declared” shall be deleted from clause (1) of such Section 5(a)(vi) of the Agreement and (b) the following sentence shall be added to the end
thereof:  “Notwithstanding  the  foregoing,  a  default  hereunder  shall  not  constitute  an  Event  of  Default  if  (i)  the  default  was  caused  solely  by  error  or
omission of an administrative or operational nature; (ii) funds were available to enable the party to make the payment when due; and (iii) the payment is
made within two Local Business Days of such party’s receipt of written notice of its failure to pay)”.
The Transaction shall be the only transaction under the Agreement. If there exists any ISDA Master Agreement between Dealer and Issuer or any
confirmation or other agreement between Dealer and Issuer pursuant to which an ISDA Master Agreement is deemed to exist between Dealer and Issuer,
then, notwithstanding anything to the contrary in such ISDA Master Agreement, such confirmation or agreement or any other agreement to which Dealer
and Issuer are parties, the Transaction shall not be considered a transaction under, or otherwise governed by, such existing or deemed to be existing ISDA
Master Agreement.
If there is any inconsistency between the Agreement, this Confirmation and the Equity Definitions, the following will prevail for purposes of the
Transaction in the order of precedence indicated: (i) this Master Confirmation; (ii) the Equity Definitions; and (iii) the Agreement.
2.    The terms of the particular Transaction to which this Confirmation relates are as follows:
GENERAL TERMS:
Trade Date:
As specified in Schedule I
Buyer:
Seller:
Shares:
Forward Price:
Discount:
10b-18 VWAP:
Observation Dates:
Calculation Period:
Final Termination Date:
Trading Day:
Initial Shares:
Initial Share Delivery Date:
Prepayment:
Prepayment Amount:
Prepayment Date:
Exchange:
Related Exchange:
Issuer
Dealer
Common Stock, par value USD 0.0001 per share, of Issuer (Ticker: ALGN)
A price per Share (as determined by the Calculation Agent) equal to the greater of (A) (i) the
arithmetic mean (not a weighted average, subject to “Market Disruption Event” below) of the 10b-
18 VWAP on each Observation Date that is a Trading Day during the Calculation Period minus (ii)
the Discount and (B) $5.00.
As specified in Schedule I
On any Trading Day, a price per Share equal to the volume- weighted average price of the Rule
10b-18 eligible trades in the Shares for the entirety of such Trading Day as determined by the
Calculation Agent by reference to the screen entitled “ALGN 
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