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OraSure Technologies, Inc.

osur · NASDAQ Healthcare
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FY2020 Annual Report · OraSure Technologies, Inc.
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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

FORM 10-K

(Mark One) 
(cid:3)

ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 

For the fiscal year ended December 31, 2020 
or 

(cid:4)

TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 

For the transition period from                      to                      
Commission File No. 001-16537 

ORASURE TECHNOLOGIES, INC.

(Exact Name of Registrant as Specified in Its Charter) 

 Delaware
(State or Other Jurisdiction of
Incorporation or Organization)

220 East First Street
Bethlehem, Pennsylvania
(Address of Principal Executive Offices)

36-4370966
(I.R.S. Employer
Identification No.)

18015
(Zip Code)

(Registrant’s Telephone Number, Including Area Code): (610) 882-1820
Securities registered pursuant to Section 12(b) of the Act: 

Title of Each Class
Common Stock, $0.000001 par value per share

Trading Symbol
OSUR

Name of Each Exchange on Which Registered
The NASDAQ Stock Market LLC

Securities registered pursuant to Section 12(g) of the Act: None 

Indicate by check mark if the Registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act.     Yes  (cid:3)    No  (cid:4)
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  (cid:4)    No  (cid:3) 
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  (cid:3)    No  (cid:4) 

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  (cid:3)    No  (cid:4) 

Indicate by check mark whether the Registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an 
emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer”, “smaller reporting company” and “emerging growth company” 
in Rule 12b-2 of the Exchange Act. 
Large accelerated filer
Non-accelerated filer

(cid:3)
(cid:4)

Accelerated filer
Smaller reporting company
Emerging Growth Company

(cid:4)
(cid:4)
(cid:4)

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 13(a) of the Exchange Act.  (cid:4) 

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. (cid:3)

Indicate by check mark whether the Registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).    Yes  (cid:4)    No  (cid:3) 
State the aggregate market value of the voting and non-voting common equity held by nonaffiliates, computed by reference to the price at which the 

common equity was last sold, or the average bid and asked price of such common equity, as of the last business day of the Registrant’s most recently 
completed second fiscal quarter (June 30, 2020): $829,039,107 

Indicate the number of shares outstanding of each of the Registrant’s classes of common stock, as of February 22, 2021: 71,945,502 shares. 

Portions of the Registrant’s Definitive Proxy Statement for the 2021 Annual Meeting of Stockholders are incorporated by reference into Part III of this 

Documents Incorporated by Reference: 

Annual Report.

Table of Contents 

PART I

ITEM 1.

Business...................................................................................................................................................................

ITEM 1A. Risk Factors .............................................................................................................................................................

ITEM 1B. Unresolved Staff Comments....................................................................................................................................

ITEM 2.

Properties.................................................................................................................................................................

ITEM 3.

Legal Proceedings ...................................................................................................................................................

ITEM 4. Mine Safety Disclosures..........................................................................................................................................

PART II

ITEM 5. Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity 

Securities.............................................................................................................................................................

ITEM 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations .................................

ITEM 7A. Quantitative and Qualitative Disclosures About Market Risk ................................................................................

ITEM 8.

Financial Statements and Supplementary Data .......................................................................................................

ITEM 9.

Changes in and Disagreements with Accountants on Accounting and Financial Disclosure .................................

ITEM 9A. Controls and Procedures..........................................................................................................................................

ITEM 9B. Other Information....................................................................................................................................................

PART III

ITEM 10. Directors, Executive Officers and Corporate Governance ......................................................................................

ITEM 11. Executive Compensation .........................................................................................................................................

ITEM 12.

Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters ...............

ITEM 13. Certain Relationships and Related Transactions, and Director Independence........................................................

ITEM 14.

Principal Accountant Fees and Services..................................................................................................................

PART IV

ITEM 15. Exhibits and Consolidated Financial Statement Schedules.....................................................................................

ITEM 16.

Form 10-K Summary ..............................................................................................................................................
Signatures ................................................................................................................................................................

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This  Report  contains  certain  “forward-looking  statements,”  within  the  meaning  of  the  Federal  securities  laws.  These  may  include 
statements  about  our  expected  revenues,  earnings,  losses,  expenses  or  other  financial  performance,  future  product  performance  or 
development, expected regulatory filings and approvals, planned business transactions, expected manufacturing performance, views 
of future industry, competitive or market conditions, and other factors that could affect our future operations, results of operations or 
financial  position.  These  statements  often  include  words,  such  as  “believes,”  “expects,”  “anticipates,”  “intends,”  “plans,” 
“estimates,” “may,” “will,” “should,” “could,” or similar expressions. 

Forward-looking statements are not guarantees of future performance or results. Known and unknown factors that could cause actual 
performance or results to be materially different from those expressed or implied in these statements include, but are not limited to: 
ability to successfully manage and integrate acquisitions of other companies in a manner that complements or leverages our existing 
business,  or  otherwise  expands  or  enhances  our  portfolio  of  products  and  our  end-to-end  service  offerings,  and  the  diversion  of 
management’s  attention  from  our  ongoing  business  and  regular  business  responsibilities  to  effect  such  integration;  the  expected 
economic  benefits  of  acquisitions  (and  increased  returns  for  our  stockholders),  including  that  the  anticipated  synergies,  revenue 
enhancement strategies and other benefits from the acquisitions may not be fully realized or may take longer to realize than expected 
and  our  actual  integration  costs  may  exceed  our  estimates;  impact  of  increased  or  different  risks  arising  from  the  acquisition  of 
companies located in foreign countries; ability to market and sell products, whether through our internal, direct sales force or third 
parties;  impact  of  significant  customer  concentration  in  the  genomics  business;  failure  of  distributors  or  other  customers  to  meet 
purchase forecasts, historic purchase levels or minimum purchase requirements for our products; ability to manufacture products in 
accordance with applicable specifications, performance standards and quality requirements; ability to obtain, and timing and cost of 
obtaining, necessary regulatory approvals for new products or new indications or applications for existing products; ability to comply 
with  applicable  regulatory  requirements;  ability  to  effectively  resolve  warning  letters,  audit  observations  and  other  findings  or 
comments from the U.S. Food and Drug Administration (“FDA”) or other regulators; the impact of the novel coronavirus (“COVID-
19”) pandemic on our business and our ability to successfully develop new products, validate the expanded use of existing collection 
products and commercialize such products for COVID-19 testing; changes in relationships, including disputes or disagreements, with 
strategic  partners  or  other  parties  and  reliance  on  strategic  partners  for  the  performance  of  critical  activities  under  collaborative 
arrangements;  ability  to  meet  increased  demand  for  the  Company’s  products;  impact  of  replacing  distributors;  inventory  levels  at 
distributors and other customers; ability of the Company to achieve its financial and strategic objectives and continue to increase its 
revenues,  including  the  ability  to  expand  international  sales;  ability  to  identify,  complete,  integrate  and  realize  the  full  benefits  of 
future  acquisitions;  impact  of  competitors,  competing  products  and  technology  changes;  reduction  or  deferral  of  public  funding 
available  to  customers;  competition  from  new  or  better  technology  or  lower  cost  products;  ability  to  develop,  commercialize  and 
market new products; market acceptance of oral fluid or urine testing, collection or other products; market acceptance and uptake of 
microbiome  informatics,  microbial  genetics  technology  and  related  analytics  services;  changes  in  market  acceptance  of  products 
based on product performance or other factors, including changes in testing guidelines, algorithms or other recommendations by the 
Centers for Disease Control and Prevention (“CDC”) or other agencies; ability to fund research and development and other products 
and  operations;  ability  to  obtain  and  maintain  new  or  existing  product  distribution  channels;  reliance  on  sole  supply  sources  for 
critical  products  and  components;  availability  of  related  products  produced  by  third  parties  or  products  required  for  use  of  our 
products;  impact  of  contracting  with  the  U.S.  government;  impact  of  negative  economic  conditions;  ability  to  maintain  sustained 
profitability; ability to utilize net operating loss carry forwards or other deferred tax assets; volatility of the Company’s stock price; 
uncertainty  relating  to  patent  protection  and  potential  patent  infringement  claims;  uncertainty  and  costs  of  litigation  relating  to 
patents  and  other  intellectual  property;  availability  of  licenses  to  patents  or  other  technology;  ability  to  enter  into  international 
manufacturing  agreements;  obstacles  to  international  marketing  and  manufacturing  of  products;  ability  to  sell  products 
internationally,  including  the  impact  of  changes  in  international  funding  sources  and  testing  algorithms;  adverse  movements  in 
foreign currency exchange rates; loss or impairment of sources of capital; ability to attract and retain qualified personnel; exposure 
to  product  liability  and  other  types  of  litigation;  changes  in  international,  federal  or  state  laws  and  regulations;  customer 
consolidations and inventory practices; equipment failures and ability to obtain needed raw materials and components; the impact of 
terrorist attacks and civil unrest; and general political, business and economic conditions. These and other factors that could affect 
our results are discussed more fully under Item 1A, entitled “Risk Factors,” and elsewhere in this Annual Report. Although forward-
looking statements help to provide information about future prospects, readers should keep in mind that forward-looking statements 
may  not  be  reliable.  Readers  are  cautioned  not  to  place  undue  reliance  on  the  forward-looking  statements.  The  forward-looking 
statements are made as of the date of this Annual Report and we undertake no duty to update these statements. 

Investors should also be aware that while we do, from time to time, communicate with securities analysts, it is against our policy to 
disclose  any  material  non-public  information  or  other  confidential  commercial  information.  Accordingly,  stockholders  should  not 
assume  that  we  agree  with  any  statement  or  report  issued  by  any  analyst  irrespective  of  the  content  of  the  statement  or  report. 
Furthermore, we have a policy against issuing or confirming financial forecasts or projections issued by others. Thus, to the extent 
that  reports  issued  by  securities  analysts  contain  any  projections,  forecasts  or  opinions,  such  reports  are  not  the  responsibility  of 
OraSure. 

1

References in this Annual Report to “OraSure” mean OraSure Technologies, Inc. References in this Annual Report to “we,” “us,” 
“our,” or the “Company” mean OraSure and its consolidated subsidiaries, unless otherwise indicated. 

2

 
PART I 

ITEM 1.

Business. 

The overall goal of our Company is to empower the global community to improve health and wellness by providing access to accurate 
essential information.  Our business is made up of two principal segments. The first is our Diagnostics business, previously named 
“OSUR”,  which  consists  primarily  of  the  development,  manufacture,  marketing  and  sale  of  oral  fluid  diagnostic  products  and 
specimen  collection  devices  using  our  proprietary  technologies,  as  well  as  other  diagnostic  products  including  immunoassays  and 
other in vitro diagnostic tests that are used on other specimen types. Our diagnostic products include tests for diseases including HIV 
and Hepatitis C that are performed on a rapid basis at the point of care and tests that are processed in a laboratory. These products are 
sold  in  the  United  States  and  internationally  to  various  clinical  laboratories,  hospitals,  clinics,  community-based  organizations  and 
other public health organizations, distributors, government agencies, physicians’ offices, and commercial and industrial entities. Our 
HIV  product  is  also  sold  in  a  consumer-friendly  format  in  the  over-the-counter  (“OTC”)  market  in  the  U.S.  and  as  a  self-test  to 
individuals in a number of other countries. Our Diagnostics business includes the operations of UrSure Inc., which we acquired and 
merged  into  OraSure  in  2020.    This  part  of  the  business  develops  and  commercializes  products  that  determine  adherence  to  HIV 
medications  including  pre-exposure  prophylaxis  or  PrEP,  the  daily  medication  to  prevent  HIV  infection.    These  products  include 
laboratory-based  tests  that  can  measure  levels  of  the  medication  in  a  patient’s  urine  or  blood,  as  well  as  point-of-care  products 
currently in development.

The  second  segment  is  our  Molecular  Solutions  business,  previously  named  “DNAG,”  which  is  operated  primarily  through  our 
subsidiaries, DNA Genotek Inc. (“DNAG”), a company based in Ottawa, Canada, Diversigen, Inc. (“Diversigen”) and Novosanis NV 
(“Novosanis”). In the Molecular Solutions business, we manufacture and sell kits that are used to collect, stabilize, transport and store 
biological  samples  of  genetic  material  for  molecular  testing.  Our  products  are  used  for  academic  research  and  commercial 
applications, including ancestry, disease risk management, lifestyle and animal testing.  Included in the disease risk management area 
are  pharmacogenomics  testing,  hereditary  disease  screening,  prenatal  or  cancer  screening,  population  health  initiatives  and  other 
molecular  testing  using  DNA  or  RNA  for  diagnosis  of  acute  disease.    We  also  sell  research  use  only  collection  products  into  the 
microbiome market. We also offer our customers a suite of genomics and microbiome services that range from package customization 
and study design optimization to extraction, analysis and reporting services. The microbiome laboratory and bioinformatics services 
are provided by Diversigen, which includes the operations of CoreBiome, Inc. (“CoreBiome”), a subsidiary we acquired in early 2019.  
CoreBiome and Diversigen were merged together in 2020.  Novosanis manufactures and sells the Colli-Pee® collection device for the 
volumetric collection of first-void urine for use in research, screening and diagnostics in the liquid biopsy and sexually transmitted 
infection markets.  Our Molecular Solutions business serves customers in many countries worldwide, including many leading research 
universities and hospitals. 

Additional  information  about  us  can  be  found  on  our  website,  www.orasure.com.  We  make  available  free  of  charge  through  a  link 
provided at such website our Annual Reports on Form 10-K, our Quarterly Reports on Form 10-Q, our Current Reports on Form 8-K 
and our other filings with the Securities and Exchange Commission (“SEC”), as well as any amendments to those Reports and filings. 
These Reports and filings are made available as soon as reasonably practicable after they are filed with or furnished to the SEC. Our 
website and the information contained in or connected to that website are not intended to be incorporated by reference into this Annual 
Report. 

Diagnostics Segment Products

The following is a summary of our principal products for the infectious disease and risk management markets, which comprise the 
Diagnostics segment of our business:

OraQuick® Rapid HIV Test 

OraQuick® is our rapid point-of-care test platform designed to test oral fluid, whole blood (i.e., both finger-stick and venous), plasma 
and  serum  samples  for  the  presence  of  various  antibodies  or  analytes.  The  device  uses  a  porous  flat  pad  to  collect  an  oral  fluid 
specimen.  After  collection,  the  pad  is  inserted  into  a  vial  containing  a  pre-measured  amount  of  developer  solution  and  allowed  to 
develop. When blood, plasma or serum is to be tested, a loop collection device is used to collect a drop of the specimen and mix it in 
the developer solution, after which the collection pad is inserted into the solution and allowed to develop. In all cases, the specimen 
and  developer  solution  then  flow  through  the  testing  device  where  test  results  are  observable  in  approximately  20  minutes.  The 
OraQuick® device is a screening test and requires a confirmation test where an initial positive result is obtained. 

3

This  product  is  sold  under  the  OraQuick  ADVANCE®  name  in  North  America,  Europe  and  certain  other  countries  and  under  the 
OraQuick®  name  in  other  developing  countries.  The  test  has  received  pre-market  approval  (“PMA”)  from  the  U.S.  Food  and  Drug 
Administration (“FDA”) for the detection of antibodies to both HIV-1 and HIV-2 in oral fluid, finger-stick whole blood, venous whole 
blood  and  plasma.  This  test  is  available  for  use  by  laboratories  located  in  the  United  States  certified  under  the  Clinical  Laboratory 
Improvements Amendment of 1988 (“CLIA”), to perform moderately complex tests. We have also received a CLIA waiver for use of 
the test with oral fluid and finger-stick and venous whole blood. As a result, the test can be used by numerous additional sites in the 
United States not certified under CLIA to perform moderately complex tests, such as outreach clinics, community-based organizations 
and physicians’ offices. 

On the international front, we have obtained a CE mark for our OraQuick ADVANCE® test so that we can sell this product in Europe 
and other countries accepting the CE mark for commercialization and this product is registered for sale in other countries. We have 
distributors in place for several countries and are seeking to increase awareness and expand our distribution network for this product 
throughout the world. We have also received World Health Organization (“WHO”) pre-qualification for our export-only version of 
this product. 

OraQuick® In-Home HIV Test 

The  OraQuick®  In-Home  HIV  test  is  an  OTC  oral-fluid  only  version  of  our  OraQuick  ADVANCE®  HIV  1/2  Antibody  Test.  We 
received PMA approval to sell this test in the U.S. OTC market. We have also received a CE mark for the OraQuick® In-Home HIV 
test,  although  this  product  is  not  currently  sold  in  the  European  Union.  The  In-Home  test  is  performed  in  the  same  manner  as  the 
OraQuick  ADVANCE®  test,  except  that  it  has  product  labeling  and  instructions  designed  for  consumers.  In  addition,  we  have 
established  toll-free,  24/7,  365-day  per  year  customer  telephone  support  to  provide  additional  information  and  referral  services  for 
consumers that use this product. 

OraQuick® HIV Self-Test 

The  OraQuick®  HIV  Self-Test  is  sold  for  use  by  individuals  in  certain  foreign  countries  at  a  lower  cost  to  meet  the  needs  of  those 
markets.  This  product  has  received  WHO  pre-qualification  and  is  eligible  for  procurement  by  purchasing  entities  entitled  to  access 
funding and other resources from the Global Fund, UNITAID and other agencies.  

OraQuick® HCV Rapid Antibody Test 

Another test available on the OraQuick® platform is the OraQuick® HCV rapid antibody test. This product is a qualitative test that can 
detect antibodies to the hepatitis C virus (“HCV”), in a variety of sample types. The OraQuick® HCV test operates in substantially the 
same manner as the OraQuick ADVANCE® HIV test. 

We have received FDA approval and CLIA waiver for use of the test in detecting HCV antibodies in venous whole blood and finger-
stick  whole  blood  specimens,  making  it  the  first  and  only  rapid  HCV  test  approved  by  the  FDA  for  use  in  the  United  States.  The 
OraQuick® HCV test has received a CE mark for use with oral fluid, venous whole blood, finger-stick whole blood, plasma and serum 
and  is  sold  in  Europe.  This  CE-marked  product  is  also  registered  and  sold  in  other  foreign  countries  and  has  received  WHO  pre-
qualification. 

OraQuick® Ebola Rapid Antigen Test 

We have received 510(k) clearance from the FDA for our rapid Ebola test, making it the first and only rapid Ebola test cleared for sale 
in the U.S. This product utilizes the OraQuick® technology platform for the detection of Ebola antigen and can be used with finger-
stick and whole blood samples from live patients and oral fluid samples from recently deceased individuals.  The uses for this test are 
limited to individuals that meet certain criteria indicating they may be infected with the Ebola virus, so the test is not available for 
general screening of individuals that do not meet this criteria.

4

OraSure® Collection Device 

Our  OraSure®  oral  fluid  collection  device  is  used  in  conjunction  with  screening  and  confirmatory  tests  for  HIV-1  antibodies.  The 
generic version of this product can be used for other analytes. This device consists of a small, treated cotton-fiber pad on a handle that 
is placed in a person’s mouth for two to five minutes. The device collects oral mucosal transudate (“OMT”), a serum-derived fluid that 
contains higher concentrations of certain antibodies and analytes than saliva. As a result, OMT testing is a highly accurate method for 
detecting HIV-1 infection and other analytes. 

The OraSure® collection device is FDA approved for use in the detection of HIV-1 antibodies. The generic version is a Class I medical 
device for the detection of cocaine and cotinine in oral fluid specimens for risk assessment testing. HIV-1 antibody detection using the 
OraSure® collection device involves three steps: 

•

•

•

Collection of an oral fluid specimen using the OraSure® device; 

Screening  of  the  specimen  for  HIV-1  antibodies  at  a  laboratory  with  an  enzyme  immunoassay  (“EIA”)  screening  test 
approved by the FDA for use with the OraSure® device; and 

Laboratory confirmation of any positive screening test results with a blood-based nucleic acid test. 

A trained health care professional then conveys test results and provides appropriate counseling to the individual who was tested. 

Intercept® Drug Testing System 

A  collection  device  that  is  substantially  similar  to  the  OraSure®  collection  device  is  sold  under  the  name  Intercept®,  and  is  used  to 
collect  oral  mucosal  transudate  or  OMT  for  oral  fluid  drug  testing.  We  have  received  FDA  510(k)  clearance  to  use  the  Intercept® 
collection device with laboratory-based EIAs to test for drugs-of-abuse commonly identified by the National Institute for Drug Abuse 
(“NIDA”) as the NIDA-5 (i.e., tetrahydrocannabinol (“THC” or marijuana), cocaine, opiates, amphetamines/methamphetamines and 
phencyclidine (“PCP”)), and for barbiturates, methadone and benzodiazepines. Each of these EIAs is also FDA 510(k) cleared for use 
with the Intercept® device. Our Intercept® device and oral fluid assays are sold in the U.S. primarily through laboratory distributors. 

We  believe  that  the  Intercept®  device  has  several  advantages  over  competing  urine  and  other  drugs-of-abuse  testing  products, 
including its lower total testing cost, its non-invasive nature, mobility and accuracy, the ease of maintaining a chain-of-custody, the 
treatment  of  test  subjects  with  greater  dignity,  no  requirement  for  specially-prepared  collection  facilities  and  difficulty  of  sample 
adulteration.  The  availability  of  an  oral  fluid  test  is  intended  to  allow  our  customers  to  test  for  drug  impairment  and  eliminate 
scheduling costs and inconvenience, thereby streamlining the testing process. 

We  have  also  developed  a  next-generation  collection  device,  which  we  are  marketing  under  the  tradename  “Intercept  i2®  he”.  This 
device offers several important advantages over our original Intercept® device, including a sample adequacy indicator that provides a 
visual prompt when the appropriate volume of oral fluid has been collected, the ability to collect a larger sample required by current 
laboratory  testing  protocols  and  a  more  optimized  chemistry  that  results  in  improved  recovery  of  the  targeted  drug  analytes.  The 
Intercept  i2®he  device  is  currently  being  sold  as  a  forensic  use  only  device  within  the  criminal  justice  and  drug  treatment  markets 
along  with  a  NIDA-5  panel  of  fully-automated  high-throughput  oral  fluid  drug  assays  that  we  distribute  under  an  agreement  with 
Thermo Fisher Scientific (“Thermo Fisher”).  Under the Thermo Fisher agreement, we intend to obtain FDA 510(k) clearance of our 
device for use with a 12-assay panel of the Thermo Fisher assays that will meet the oral fluid drug testing guidelines issued by the 
Substance Abuse and Mental Health Services Administration (“SAMHSA”).

Immunoassay Tests and Reagents 

We develop and sell immunoassay tests in formats, known as MICRO-PLATE and AUTO-LYTE®, to meet the specific needs of our 
customers. We also sell fully-automated high-throughput oral fluid drug assays developed under our agreement with Thermo Fisher. 
Our  MICRO-PLATE  tests  can  be  performed  on  commonly  used  instruments  and  can  detect  drugs  in  urine,  serum  and  sweat 
specimens. MICRO-PLATE tests are also used as part of the Intercept® product line to detect drugs-of-abuse in oral fluid specimens 
and we are selling a NIDA-5 panel of microplate assays supplied by Thermo Fisher to the U.S. forensic market under the agreement 
described above. AUTO-LYTE® tests are sold in the form of bottles of liquid reagents, are run on commercially available laboratory-
based  automated  analytical  instruments,  and  are  typically  used  in  high  volume,  automated,  commercial  reference  insurance 
laboratories to detect certain drugs or chemicals in urine. 

5

Q.E.D.® Saliva Alcohol Test 

Our Q.E.D.® saliva alcohol test is a point-of-care test device that is a cost-effective alternative to breath or blood alcohol testing. The 
test is a quantitative, saliva-based method for the detection of ethanol, has been cleared for sale by the FDA and has received a CLIA 
waiver. The U.S. Department of Transportation (“DOT”) has also approved the test. 

Each  Q.E.D.®  test  kit  contains  a  collection  stick  that  is  used  to  collect  a  sample  of  saliva  and  a  disposable  detection  device  that 
displays results in a format similar to a thermometer. The Q.E.D.® device is easy to operate and instrumentation is not required to read 
the result. The product has a testing range of 0 to 0.145% blood alcohol and produces results in approximately two minutes. 

Molecular Solutions Segment

Genomic Products

We sell a number of genomic products that provide all-in-one systems for the collection, stabilization, transportation, and storage of 
DNA and/or RNA from human and animal biologic samples. Our lead products are sold under the Oragene® and ORAcollect® brands 
and are used to collect genetic material from human saliva. These products are currently sold to thousands of academic research and 
commercial customers in many countries worldwide. 

Our genomic products are available in several different configurations and contain proprietary chemical solutions that are optimized 
for the specific application for which each product is designed. Product physical design is focused on ease-of-use and reliability for 
self or assisted collection of samples. For example, several of the Oragene® products require users to simply hold the product close to 
their mouth and spit into the collection device. When the container is closed, the reagents stored in the lid of the container are mixed 
with the captured saliva and immediately protect the nucleic acids in the sample. This non-invasive collection method yields nucleic 
acid  that  remains  stable  at  ambient  temperature  for  extended  periods.  The  stabilizing  technology  results  in  high  quality  and  high 
quantity nucleic acids that are required for most genetic testing and analysis methods. 

We believe these products provide significant advantages over competing DNA and RNA collection methods such as blood collection 
or buccal swabs, particularly in human genetic applications. Benefits include the reliable collection of high-quality and stable genetic 
samples, use of simple non-invasive collection methods, the ability to store and transport collected samples for extended periods at 
ambient temperatures and compatibility with fully-automated laboratory testing systems. 

We also sell the Colli-Pee® collection device for the volumetric collection of first void urine samples.  This product is used in liquid 
biopsy applications for the prostate and bladder cancer markets and in the sexually transmitted infection screening market.

COVID Products

During 2020, we actively engaged with several laboratories and researchers to demonstrate the effectiveness of our existing collection 
products for use with COVID-19 molecular testing.    The stabilization solution in our molecular collection products can accommodate 
a very broad spectrum of microbiome activity spanning bacteria to viruses and we have collected data on the usability of our kits for 
this purpose.  We believe that oral samples collected using devices from our product lines for liquid saliva or oral swab samples are a 
suitable alternative to more commonly used samples collected with a nasopharyngeal or oropharyngeal swab.  Unlike nasopharyngeal 
and  oropharyngeal  swabs  which  cannot  be  self-administered  easily,  our  products  are  optimized  for  self-collection.    That  means 
healthcare providers, retailers, and online vendors could ship our kits directly to an individual’s home, eliminating unnecessary trips to 
hospitals, doctors’ offices and testing facilities.  Self-collection would also support the social distancing guidelines already in place in 
many  communities,  reduce  the  burden  on  testing  sites  and  healthcare  facilities,  and  provide  wider  access  to  testing.  Moreover, the 
chemistry in our products stabilizes nucleic acids, including RNA, which is the nucleic acid used by most labs for COVID-19 testing. 
The usability and form factor of these products are conducive to use in at-home or clinic settings.

As a result, during 2020 we began selling our ORAcollect® • RNA and OMNIgene® • ORAL collection devices for use in connection 
with  COVID-19  molecular  testing.    These  products  have  become  an  increasingly  important  part  of  our  business  and  accounted  for 
47% of 2020 revenue generated by our Molecular Solutions segment.

6

Microbiome Products.  

We also market several microbiome collection products designed to collect, stabilize and transport the microbial profile from multiple 
sample types. Unlike genomic DNA, the microbiome of a sample can change over time, especially when exposed to temperature and 
environment  fluctuations.  In  order  to  optimize  and  standardize  sample  results,  a  reliable  method  that  captures  and  preserves 
(“snapshots”) the microbiome after collection until analysis is required. We believe our products provide such a reliable method. 

Our OMNIgene® • GUT product is an all-in-one system designed to enable an individual to easily self-collect high quality microbial 
DNA  from  feces  or  stool  samples  for  gut  microbiome  profiling  for  use  in  clinical  laboratory  and  research  settings.    Current 
methodologies  for  gut  microbiome  profiling  have  distinct  shortcomings  due  to  the  introduction  of  bias,  leading  to  a  lack  of 
reproducibility in the field.  Our product ensures that the fecal sample is fully stabilized immediately upon collection and maintains an 
accurate and reliable bacterial profile for weeks at room temperature. We have also begun marketing other microbiome collection kits 
for skin, vaginal and oral samples. 

Laboratory and Data Analytical Services.  

Our  Molecular  Solutions  business  also  offers  our  customers  microbiome  laboratory  testing  and  analytical  services.    These  services 
reflect the collective services of our CoreBiome and Diversigen subsidiaries, which were combined under the Diversigen name during 
2020.  Our  services  focus  on  accelerating  microbiome  discovery  for  customers  in  the  pharmaceutical,  agriculture,  and  research 
communities,  to  unleash  the  translational  potential  of  the  microbiome  and  provide  fast  and  information-rich  characterizations  of 
microbial diversity and function paired with expert analytics. We also provide comprehensive microbiome and metagenomics services 
focused on solutions to improve human, animal and environmental health.  Diversigen has extensive experience with highly diverse 
microbiome  sample  types  and  provides  full  project  life  cycle  consulting  services,  including  pre-project  consulting,  study  design, 
extraction  and  sequencing  to  complete  bioinformatics  analysis.    Diversigen  is  at  the  forefront  for  setting  quality  standards  for  this 
industry and is in the process of obtaining College of American Pathologists (“CAP”) accreditation at its laboratory facilities.   We are 
also in the process of integrating the services offered through GenoFINDTM, CoreBiome and Diversigen into a unified offering and 
brand for our customers.

Regulatory Approvals.  

Our Molecular Solutions products historically have been sold primarily as Class I medical devices for use by research and academic 
institutions.  We  have  received  FDA  510(k)  clearance  of  the  Oragene®  •  DX  product  for  use  with  the  eSensor®  Warfarin  sensitivity 
saliva test. A separate 510(k) clearance permits self-collection by consumers when the sample is to be tested with either an exempt or 
510(k) cleared molecular test. More recently, we received a generic 510(k) clearance for this product, which we believe will further 
broaden the use of our Oragene®• DX device. Our ORAcollect® product similarly received 510(k) clearance from the FDA. We have 
also received CE mark approval for the Oragene® • DNA, ORAcollect® and OMNIgene® • GUT collection kits. Diversigen provides 
molecular services in CLIA-certified laboratories and as noted above, and is in the process of obtaining CAP accreditation.

With respect to COVID testing, our collection devices have been included in FDA Emergency Use Authorizations (“EUAs”) granted 
to a number of third parties for use with COVID-19 molecular test offerings.  These EUAs permit the use of our devices in healthcare 
settings  or  in  some  cases  in  at-home  or  unsupervised  settings  for  the  collection  of  samples.    Our  DNA  Genotek  subsidiary  also 
received  FDA  EUAs  for  the  use  of  its  OMNIgene®  •ORAL  and  ORAcollect®  •RNA  collection  devices  in  COVID-19  testing  which 
allows for the unsupervised use of these devices at home or in healthcare settings when used as part of an approved or validated at-
home  test  kit.    With  these  FDA  authorizations,  the  OMNIgene®  •  ORAL  and  ORAcollect®  •RNA  devices  can  be  used  for  the  self-
collection, transport and laboratory testing of saliva specimens suspected of containing SARS-CoV-2 ribonucleic acid (RNA), without 
the presence of a healthcare professional, before sending the sample to a lab for analysis. These products are also CE marked for in 
vitro diagnostic use, including for COVID-19 testing, in the European Union.

Products Under Development 

Diagnostic Products

Our  research  and  development  efforts  include  programs  targeted  at  expanding  and  enhancing  our  diagnostics  business.  These 
programs typically focus on products related to drug monitoring, rapid tests for diseases other than HIV and HCV and drug testing.  In 
2020,  significant  time  and  resources  were  dedicated  to  the  development  of  our  COVID-19  Rapid  Antigen  Self-Test.    Subject  to 
regulatory approvals, the Company intends to introduce its antigen test to the market for three different uses: 

7

(cid:3)

(cid:3)

Professional Test for use at drive-through sites, physician offices, public health testing sites, and employer/university 
health  centers.  In  this  instance,  a  physician  would  prescribe  the  test  and  the  patient  would  conduct  a  self-swab  in  the 
presence of a healthcare provider who would then interpret the result.
Prescription  Self-Test  for  use  by  individual  consumers  (with  prescription)  at  home  or  in  any  location,  by 
employers/universities on- or off-site, or by physicians or public health via remote testing. In this instance, a physician 
would prescribe the test and the patient would conduct a self-swab at home, or in any location, where they would then 
interpret their own result.

(cid:3) OTC Self-Test for use by consumers who would purchase online or at retail without prescription, and conduct the test 

and receive the result themselves anytime, anywhere.

We have completed development of the COVID-19 Rapid Antigen Self-Test and have collected all clinical study data to submit both 
the Prescription Self-Test and the Professional Test versions of this product for EUA at the same time, which is expected to occur in 
the first quarter of 2021.  Subject to receipt of EUA, this product would test for active COVID-19 infection using nasal samples self-
collected from the lower nostril.  After we submit the Professional Test and Prescription Self-Test for EUA, we intend to continue 
plans to pursue an OTC claim.  

During the third quarter of 2020, limit of detection studies for the assay were completed with live coronavirus in a certified third party 
analytical laboratory, with results comparable to that of another EUA approved, instrument-free, rapid antigen test. The results from 
the limit of detection comparison provides further confidence that the proprietary chemistries incorporated on OraSure’s lateral flow 
test strip will deliver the analytical sensitivity needed. Although the timing of EUA approval is subject to FDA review, the Company 
will be prepared to launch the test, subject to authorization, without delay following such approval.  Subject to receipt of EUA, this 
product would test for active COVID-19 infection using nasal samples collected from the lower nostril. Results would be available at 
the point of collection, with no special instrumentation needed to interpret result.

In  addition  to  a  rapid  antigen  self-test,  we  are  developing  a  lab-based  oral  fluid  microplate  SARS-CoV-2  antibody  enzyme-linked 
immunosorbent assay (“ELISA”). The OraSure SARS-CoV-2 Antibody ELISA is intended for qualitative detection of total antibodies 
(including  IgM/IgA/IgG)  to  SARS-CoV-2  in  human  oral  fluid  specimens  collected  with  the  OraSure  Oral  Antibody  Collection 
Device. To date, there are no oral fluid antibody tests for COVID-19 authorized for sale in the U.S.  Oral sample collection is quick, 
painless, non-invasive and requires less human contact in comparison to a blood draw, minimizing the need for personal protective 
equipment and exposure to potentially infected patients. With this test, individuals would use a collection pad to self-collect an oral 
fluid  sample  under  the  observation  of  a  healthcare  professional.  The  sample  would  then  be  placed  into  the  OraSure  oral  antibody 
collection device buffer for storage and transport, and then later dispensed onto the ELISA microplate for testing in a laboratory. The 
lab-based  antibody  test  can  aid  in  identifying  individuals  with  an  adaptive  immune  response  to  SARS-CoV-2,  indicating  recent  or 
prior infection. Antibody tests are well suited for community surveillance and seroprevalence studies to identify people in a population 
or community that have antibodies against an infectious disease such as COVID-19. In addition, the OraSure SARS-COV-2 Antibody 
ELISA can detect antibodies developed from vaccination.

In October 2020, the Company submitted an EUA application to the FDA for its SARS-CoV-2 Antibody ELISA test and in December 
2020,  the  FDA  requested  additional  information  as  part  of  its  review  of  our  EUA  submission.    At  the  FDA’s  request,  we  are 
performing additional analytical studies on sample collection and stability and, after data from these studies have been obtained, we 
intend to resubmit two separate EUAs – one for the ELISA and one for the collection device.

During  2020,  a  significant  amount  of  time  was  also  devoted  to  the  oral  fluid  drug  assay  development  efforts  with  Thermo  Fisher.   
Another  development  area  focused  on  increasing  the  number  of  country  registrations  for  our  HIV  Self-Test.    Finally,  we  are  also 
working to develop a rapid point-of-care assay to determine HIV drug adherence to be sold in the same markets where we currently 
sell our HIV diagnostic products.

Molecular Solutions 

In  order  to  intersect  evolving  customer  needs  within  the  academic  and  commercial  markets,  our  molecular  business  product 
development  pipeline  is  focused  on  extending  offerings  across  different  sample  types  and  analytes  within  both  the  genomics  and 
microbiome  areas.  Genomic  customers  are  demonstrating  an  increasing  demand  for  RNA  collection  and  stabilization.  On  the 
microbiome  front,  we  continue  to  focus  research  and  development  work  on  collecting  and  stabilizing  microbial  DNA,  RNA  and 
metabolites from multiple sample types including gut, skin, vagina and saliva. We are also evolving the physical design and features 
of our products to further enable high throughput processing through improved interoperability with automated platforms. 

The field of microbiome services is fast paced with evolving biological understanding and development of new methodologies.  Our 
development efforts are focused on remaining at the forefront of technology, as well as providing new and relevant services to our 
customers.  These development goals are being pursued while we also leverage new sequencing technologies and methodologies to 
enable scalability for our business.

8

Sales and Marketing 

We  attempt  to  reach  our  major  target  markets  through  a  combination  of  direct  sales,  strategic  arrangements  and  independent 
distributors. Our marketing strategy is to create or raise awareness through a full array of marketing activities, which include trade 
shows, print advertising, special programs, distributor promotions, telemarketing and the use of digital and social media in order to 
stimulate sales in each target market. 

We market our products in the United States and internationally. Consolidated net revenues attributable to customers in the United 
States  were  $130.8  million,  $107.3  million  and  $136.8  million  in  2020,  2019  and  2018,  respectively.  Consolidated  net  revenues 
attributable to international customers amounted to $40.9 million, $47.3 million and $44.9 million, or 24%, 31% and 25% of our total 
revenues, in 2020, 2019 and 2018 respectively. For more information about our revenues and long-lived assets attributable to U.S. and 
international customers, please see Notes 2 and 13 to our consolidated financial statements included elsewhere in this Annual Report. 

Diagnostics - Professional 

We market the OraQuick ADVANCE® HIV-1/2 antibody test directly to customers in the public health market for HIV testing. This 
market  consists  of  a  broad  range  of  clinics  and  laboratories  and  includes  states,  counties,  and  other  governmental  agencies,  family 
planning  clinics,  colleges  and  universities,  correctional  facilities  and  the  military.  There  are  also  a  number  of  organizations  in  the 
public health market, such as AIDS service organizations and various community-based organizations, that are set up primarily for the 
purpose of encouraging and enabling HIV testing. We sell our OraQuick ADVANCE® test directly to hospitals in the U.S. primarily 
through distributors. We also use distributors to sell our OraQuick ADVANCE® test into the U.S. physician office market and to retail 
clinics operated by pharmacies. In addition, we distribute our OraQuick® HIV test in certain foreign countries through distributors. 

Our OraQuick® HCV test is sold primarily to the same markets where our OraQuick® ADVANCE HIV test is sold, including public 
health organizations, hospitals, physicians and retail clinics. We also sell this test in other countries through distributors.  

Diagnostics - OTC and Self-Test

We sell our OraQuick® In-Home test in the U.S. retail or consumer market. Retailers carrying the product include CVS, Walgreens, 
Rite  Aid  and  Walmart.  The  product  is  also  available  for  purchase  on-line  through  certain  retailers  and  from  our  website, 
www.oraquick.com.  The  primary  target  population  for  our  HIV-OTC  test  comprises  young,  sexually  active  adults,  with  greater 
purchase intent found in high-risk sub-groups, such as men who have sex with men, African Americans and Latino Americans. 

We also sell our OraQuick® HIV Self-Test in certain international markets.  Under a Charitable Support Agreement with the Bill & 
Melinda  Gates  Foundation  (“Gates  Foundation”)  we  are  able  to  offer  our  OraQuick®  HIV  Self-Test  at  an  affordable  price  in  50 
developing countries in Africa and Asia with funding from the Gates Foundation. The funding consists of support payments tied to the 
volume of product we sell and reimbursement of certain related costs. The agreement was entered into in 2017 and has a four-year 
term  and  enables  non-governmental  organizations  in  the  eligible  countries  that  receive  funding  from  government  or  public  sector 
agencies  and  donors  to  access  our  HIV  Self-Test  at  reduced  pricing.  The  agreement  with  the  Gates  Foundation  provides  for  an 
aggregate funding amount not to exceed $20.0 million over the four-year term or $6.0 million each year of the agreement.  The term of 
this agreement expires in 2021.

Our  OraQuick®  HIV  Self-Test  is  the  only  oral  fluid  HIV  test  prequalified  by  the  WHO.  WHO  prequalification  helps  ensure  that 
diagnostic  tests  for  high  burden  diseases  meet  global  standards  of  quality,  safety,  and  efficacy  in  order  to  optimize  use  of  health 
resources  and  improve  health  outcomes.  WHO  prequalification  enables  governmental  organizations  implementing  HIV  Self-Test 
pilots and programs to access international funding to purchase our test. 

Substance Abuse Testing 

Our substance abuse testing products are marketed to laboratories serving the workplace testing, forensic toxicology, criminal justice 
and drug rehabilitation markets in the U.S. and certain international markets. 

We  have  entered  into  agreements  for  the  distribution  of  our  Intercept®  collection  device  and  associated  MICRO-PLATE  assays  for 
drugs-of-abuse  testing  in  the  workplace  testing  market  in  the  United  States  and  Canada  through  several  laboratory  distributors and 
internationally for workplace, criminal justice and forensic toxicology testing through other distributors. We also market the Intercept® 
collection device on its own and as a kit in combination with laboratory testing services. To better serve our workplace customers, we 
have contracted with commercial laboratories to provide prepackaged Intercept® test kits, with prepaid laboratory testing and specimen 
shipping costs included. 

9

The criminal justice market in the United States for our substance abuse testing products consists of a wide variety of entities in the 
criminal justice system that require drug screening, such as pre-trial services, parole and probation offices, police forces, drug courts, 
prisons, drug treatment programs and community/family service programs. The forensic toxicology market consists of several hundred 
laboratories including federal, state and county crime laboratories, medical examiner laboratories and reference laboratories. 

As discussed above, we also sell our next generation Intercept i2® collection device with a NIDA-5 panel of fully-automated high-
throughput oral fluid assays developed with Thermo Fisher for the detection of PCP, THC, opiates, cocaine, methamphetamines and 
amphetamines.  These  products  are  currently  sold  into  the  criminal  justice  and  drug  treatment  markets.  Under  our  Thermo  Fisher 
agreement, we intend to obtain FDA 510(k) clearance of our Intercept i2® device for use with the NIDA-5 assay panel, along with an 
additional six fully-automated high-throughput assays in order to expand sales of this product line into the workplace testing market 
and other markets that require 510(k) cleared drug tests. These products are expected to meet recent oral fluid drug testing guidelines 
issued by SAMHSA, which will enable us to expand sales into markets where employee drug testing is federally regulated. 

We  distribute  our  Q.E.D.®  saliva  alcohol  test  primarily  through  various  distributors  in  the  United  States  and  internationally.  The 
markets for alcohol testing are relatively small and fragmented with a broad range of legal and procedural barriers to entry. Markets 
range  from  law  enforcement  testing  to  workplace  testing  of  employees  in  safety  sensitive  occupations.  Typical  usage  situations 
include pre-employment, random, post-accident, reasonable-cause and return-to-duty testing. 

Molecular Solutions

Our  Molecular  Solutions  business  sells  its  products  directly  to  its  customers,  primarily  through  its  own  internal  sales  force  and  in 
many international markets, distributors are used. 

Most of our Molecular Solutions revenues are derived from product sales to commercial customers and sales into the academic and 
research markets. Sales to commercial customers providing consumer genetics and clinical diagnostic services have been increasing 
and  account  for  a  majority  these  revenues.  A  significant  portion  of  total  sales  are  derived  from  repeat  customers  in  both  markets. 
Molecular Solutions also has customers in the livestock and companion animal markets. 

We  have  expanded  the  market  focus  of  our  Molecular  Solutions  business  by  selling  certain  existing  collection  products  for  use  in 
COVID-19  tests  and  by  developing  new  collection  devices  for  the  emerging  microbiome  market,  which  is  focused  on  the  study  of 
microbes and their effect on human health. Our primary product offering in the microbiome market, OMNIgene® • GUT, is focused on 
the  human  gut  microbiome  (microbes  living  in  human  stool).  We  are  leveraging  our  existing  sales  force  and  global  research 
connections to engage microbiome customers around the world to establish itself as the leader in ease-of-collection, stabilization and 
transport of this challenging sample type.  

Our Molecular Solutions segment includes the Colli-Pee® device, a product developed and sold by our Novosanis subsidiary, for the 
volumetric collection of first void urine.  This product is in its early stages and initial sales are occurring primarily through distributors 
and collaborations for use in the liquid biopsy and sexually transmitted disease markets.

This segment is offering laboratory and analytical services for both genomics and microbiome customers in order to more fully meet 
the needs of its customers.  These services are primarily provided to pharmaceutical and biotech companies and research institutions.  
During 2019, we substantially expanded our ability to offer microbiome laboratory and bioinformatics services with the acquisition of 
CoreBiome and Diversigen.  The laboratory operations of CoreBiome and Diversigen were combined during 2020 so that we can now 
provide a single-integrated offering to our customers under the Diversigen brand.

Significant Products and Customers 

Several different product lines have contributed significantly to our financial performance, accounting for 10% or more of our total 
revenues during the past three years. The table below shows a breakdown of those product lines (dollars in thousands). 

Genomics......................................................................   $37,141
OraQuick® HIV ............................................................     44,224
COVID-19....................................................................     49,802

  For the years ended December 31,
    2019
  2020
   $56,200
     43,092
     —

    2018
   $79,765
     41,457
     —

One of our customers accounted for approximately 15% and 24% of our net consolidated revenues in 2019 and 2018, respectively. We 
had no customers in 2020 that accounted for more than 10% of our net consolidated revenues.

10

 
 
 
 
 
 
 
Supply and Manufacturing 

We  manufacture  all  of  our  OraQuick ADVANCE®  HIV  test,  OraQuick®  In-Home  HIV  test,  OraQuick®  HCV  test,  OraQuick®  Ebola 
test, OraSure®, Intercept® and Intercept i2® collection devices, AUTOLYTE and MICRO-PLATE assays and QED® saliva alcohol test 
in  our  Bethlehem,  Pennsylvania  facilities.  We  expect  to  continue  to  manufacture  these  products  at  this  location  for  the  foreseeable 
future. 

We have contracted with a third party in Thailand for the assembly of the OraQuick® HIV device and the OraQuick® HIV Self-Test in 
order to supply certain international markets. We believe that other firms would be able to assemble these OraQuick® tests on terms no 
less favorable than those set forth in the agreement if the Thailand contractor would be unable or unwilling to continue assembling this 
product. 

We can purchase the HIV antigens, the nitrocellulose and certain other critical components, and the HCV and Ebola antigens used in 
our OraQuick® product lines only from a limited number of sources. If for any reason these suppliers are unwilling or no longer able to 
supply our antigen or nitrocellulose needs, we believe that alternative supplies could be obtained at a competitive cost. However, a 
change in any of the antigens, the nitrocellulose or other critical components used in our products would require FDA approval and 
some additional development work. This in turn could require significant time to complete, increase our costs and disrupt our ability to 
manufacture and sell the affected products. 

We intend to manufacture our COVID-19 Rapid Antigen Self-Test and OraSure SARS-CoV-2 Antibody ELISA in our Bethlehem, 
Pennsylvania facilities.  In addition, we plan to manufacture our COVID-19 Rapid Antigen Self-Test at a third party in Thailand in 
order to supply certain international markets.  We made significant capital investments during 2020 and will continue to invest to add 
the  manufacturing  capacity  needed  to  meet  the  expected  demand  for  these  products.    Specifically,  we  plan  to  add  capacity  of  70 
million tests per year (which includes tests for HIV, HCV and Ebola) to meet demand for the COVID-19 Rapid Antigen Self-Test in 
the U.S. by the third quarter of 2021, and capacity for an additional 50 million tests per year by the second quarter of 2022 to support 
sales of this product outside of the U.S.  We expect to add capacity of 20 million tests per year (including existing products) to meet 
demand for our OraSure SARS-CoV-2 Antibody ELISA by the fourth quarter of 2021.

Our MICROPLATE and AUTO-LYTE assays require the production of highly specific and sensitive antibodies corresponding to the 
antigen of interest. Substantially all our antibody requirements are provided by contract suppliers. We believe that we have adequate 
reserves of antibody supplies and that we have access to sufficient raw materials for these products. 

The fully-automated high-throughput oral fluid drug assays sold with our new Intercept i2® collection device are manufactured and 
supplied under a long-term agreement with Thermo Fisher. There is no other supply source for these products. 

DNAG has three long-term contract manufacturing relationships to supply virtually all of its products, including the Oragene® product 
line. Many of the raw materials and components used in these products are also purchased from third parties, including one critical 
component that is purchased from a sole source supplier. We believe there are other suppliers that can manufacture and supply the raw 
materials and components for the DNAG products. We are increasing capacity for our molecular collection kits to meet demand for 
COVID molecular testing to 80 million kits per year (including non-COVID kits) by the third quarter of 2021.

Our Colli-Pee® device is currently manufactured at our Belgian assembly facility with components supplied by third party vendors.

Our GenoFINDTM genomics laboratory services are provided to our customers by a third party laboratory.  We believe there are other 
laboratories  that  can  also  provide  these  services.    Our  microbiome  laboratory  testing  and  analytical  services  are  provided  by  our 
subsidiary, Diversigen.

11

Human Capital Resources 

In  order  to  achieve  the  goals  and  expectations  of  our  Company,  it  is  crucial  that  we  continue  to  attract  and  retain  top  talent.    To 
facilitate  talent  attraction  and  retention,  we  strive  to  make  OraSure  a  safe  and  rewarding  workplace  with  opportunities  for  our 
employees to grow and develop in their careers.

As of December 31, 2020, we had 570 full-time employees, which compares to 472 employees as of December 31, 2019. The increase 
in employees during 2020 was primarily the result of the need to add manufacturing capacity for our COVID-19 Rapid Antigen Self-
Test and molecular collection devices used in COVID-19 molecular testing.  Our employees are not currently represented by a U.S. 
collective bargaining agreement.

We believe our employees are among our most important resources and are critical to our continued success.  We focus significant 
attention to attracting and retaining talented and experienced individuals to manage and support our operations, and our management 
team  routinely  reviews  employee  turnover  rates  at  various  levels  of  the  organization.    Management  also  reviews  employee 
engagement and satisfaction surveys to monitor employee morale and receive feedback on a variety of issues.

The  health  and  safety  of  our  workforce  is  fundamental  to  the  success  of  our  business.    We  safeguard  our  people,  projects  and 
reputation by striving for zero employee injuries and illnesses, while operating and delivering our work responsibly and sustainably.  
We  provide  our  employees  upfront  and  ongoing  safety  training  to  ensure  that  safety  policies  and  procedures  are  effectively 
communicated and implemented.  Personal protective equipment is provided to those employees where needed for the employee to 
safely perform their job function.

During 2020, in response to the COVID-19 pandemic, we implemented safety protocols and new procedures to protect our employees, 
our subcontractors and our customers.  These protocols include complying with social distancing and other health and safety standards 
as required by federal, state and local government agencies, taking into consideration guidelines of the Centers for Disease Control 
and  Prevention  and  other  public  health  authorities.    In  addition,  we  modified  the  way  we  conduct  many  aspects  of  our  business  to 
reduce the number of in-person interactions.  For example, we significantly expanded the use of virtual interactions in all aspects of 
our  business,  including  customer  facing  activities.    Many  of  our  administrative  and  operational  functions  during  this  time  have 
required modification as well, including much of our workforce working remotely.

As part of our compensation philosophy, we believe that we must offer and maintain market competitive compensation and benefits 
programs  for  our  employees  in  order  to  attract  and  retain  superior  talent.    In  addition  to  healthy  base  wages,  additional  programs 
include annual bonus opportunities, a Company matched 401(k) Plan or other savings plan, healthcare and insurance benefits, health 
savings and flexible spending accounts, paid time off, family leave, flexible work schedules, and employee assistance programs.

The OraSure family of companies is committed to creating and fostering a diverse, equitable, and inclusive workplace that reflects and 
contributes  to  the  global  communities  in  which  we  do  business  and  the  customers  and  partners  we  serve.    This  includes  all 
communities  impacted  by  our  corporate  presence.      Our  management  teams  and  all  of  our  employees  are  expected  to  exhibit  and 
promote honest, ethical and respectful conduct in the workplace.  All of our employees must adhere to a Code of Conduct that sets 
standards for appropriate behavior and includes required annual training on preventing, identifying, reporting and stopping any type of 
unlawful discrimination. We strive to recruit the best people for the job regardless of gender, ethnicity or other protected trait and it is 
our  policy  to  fully  comply  with  all  laws  (domestic  and  foreign)  applicable  to  discrimination  in  the  workplace.  We  have  an  active 
Diversity,  Equity  and  Inclusion  Council  that  strives  to  drive  diversity,  equity  and  inclusion  within  the  workplace.    At  OraSure,  we 
believe a variety of perspectives are critical to achieving success, and that diversity, equity and inclusion are key drivers to growth-
based innovation and profitability.  We aim to create a culture where all people feel valued, supported, and inspired to be themselves 
fearlessly, without judgement.  We believe that when all voices are heard, we honor and exemplify our core values and best serve our 
communities.

Competition 

Diagnostics Segment

The  diagnostic  industry  is  a  multi-billion  dollar  international  industry  and  is  intensely  competitive.  Many  of  our  competitors  are 
substantially larger than we are, and have greater financial, research, manufacturing and marketing resources than we do. 

The  primary  competitive  factors  for  our  products  include  price,  quality,  performance,  ease  of  use,  customer  service  and  reputation. 
Industry competition is based on these and the following additional factors: 

•

•

•

Scientific and technological capability; 

Proprietary know-how; 

The ability to develop and market products and processes; 

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•

•

•

The ability to obtain FDA or other regulatory approvals; 

The ability to manufacture products that meet applicable FDA or other applicable regulatory requirements; 

Commercial execution and strength of distribution; 

• Access to adequate capital; 
•

The ability to attract and retain qualified personnel; and 

•

The availability of patent protection. 

A few large corporations produce a wide variety of diagnostic tests and other medical devices and equipment. A larger number of mid-
size companies generally compete only in the diagnostic industry and a significant number of small companies produce only a few 
diagnostic products. As a result, the diagnostic test industry is highly fragmented and segmented. 

The  future  market  for  diagnostic  products  is  expected  to  be  characterized  by  greater  cost  consciousness,  the  development  of  new 
technologies, tighter reimbursement policies and consolidation. The purchasers of diagnostic products are expected to place increased 
emphasis  on  lowering  costs,  reducing  inventory  levels,  obtaining  better  performing  products,  automation,  service  and  volume 
discounts. The increased complexity of the market is expected to force many competitors to enter into joint ventures or license certain 
products or technologies. 

We expect competition to intensify as technological advances are made and become more widely known, and as new products reach 
the  market.  Furthermore,  new  testing  methodologies  could  be  developed  in  the  future  that  render  our  products  impractical, 
uneconomical or obsolete. There can be no assurance that our competitors will not succeed in developing or marketing technologies 
and products that are more effective than those we develop or that would render our technologies and products obsolete or otherwise 
commercially  unattractive.  In  addition,  there  can  be  no  assurance  that  our  competitors  will  not  succeed  in  obtaining  regulatory 
approval  for  these  products,  or  introduce  or  commercialize  them,  before  we  can  do  so.  These  developments  could  have  a  material 
adverse effect on our business, financial condition and results of operations. 

Several companies market or have announced plans to market oral specimen collection devices and tests both within and outside the 
United  States.  We  expect  the  number  of  devices  competing  with  our  OraQuick®,  OraSure®,  Intercept®  and  Intercept  i2®  devices  to 
increase as the benefits of oral fluid-based testing become more widely accepted. 

Competition in the U.S. market for infectious disease testing in medical settings is intense and is expected to increase. Our principal 
competition  for  HIV  testing  in  the  professional  market  comes  from  existing  and  new  point-of-care  rapid  blood  tests,  automated 
laboratory-based  blood  tests,  or  other  oral  fluid-based  tests.  Our  competitors  sell  both  a  rapid  oral  fluid  HIV  test  and  a  rapid  HIV 
antigen/antibody  test  that  are  both  FDA  approved  and  CLIA  waived.  Our  OraQuick®  rapid  HCV  test  competes  against  laboratory-
based blood tests in the U.S., as there currently are no other rapid HCV testing products approved by the FDA. 

Our  competitors  in  the  domestic  infectious  disease  testing  market  include  medical  diagnostic  companies  and  specialized 
biotechnology  firms,  as  well  as  pharmaceutical  companies  with  biotechnology  divisions.  Competing  tests  are  often  sold  at  a  lower 
price  than  we  charge  for  our  products.  This  competition  can  result  in  lost  sales  and  degradation  of  the  price  (and  therefore  the 
applicable profit margins) we can charge for our HIV and HCV tests. 

Outside  the  U.S.,  our  rapid  HIV  and  HCV  tests  compete  against  other  rapid  and  laboratory-based  tests.  Significant  sales  of  these 
products  in  Europe  have  not  materialized  principally  because  of  differences  in  European  healthcare  systems  compared  to  U.S. 
systems.  Unlike  in  the  U.S.,  adoption  of  rapid  point-of-care  diagnostics  is  not  widespread  in  Europe  because  laboratory  testing  is 
entrenched and healthcare systems are structured around centralized testing models. In addition, many competing tests in international 
markets are sold at very low prices. We intend to continue to build awareness and develop strategies to expand sales of our OraQuick® 
HIV and HCV tests in European and other international markets. 

Our OraQuick® In-Home HIV oral fluid test is the only rapid HIV test approved by the FDA for sale in the U.S. OTC market. We 
compete against one other non-rapid HIV blood test available in the OTC market, which requires consumers to self-collect a blood 
sample and then send it to a laboratory for testing. We expect that other non-rapid HIV blood tests will eventually compete with our 
product. The OraQuick® HIV Self-Test that we sell in certain international markets is facing competition from other blood-based rapid 
HIV self-tests. 

In  the  United  States  there  are  currently  four  rapid  COVID-19  self-tests  on  the  market  that  are  expected  to  compete  against  our 
COVID-19  Rapid  Antigen  Self-Test.    There  are  several  other  Professional  point  of  care  COVID-19  antigen  tests  with  EUA  in  the 
United States which are expected to compete with the Professional use version of our antigen test.  In addition, there are a number of 
COVID-19 blood-based antibody tests sold in the U.S. market that are expected to compete against our OraSure SARS-CoV-2 Oral 

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Fluid Antibody ELISA. We also expect additional rapid COVID-19 antigen tests and COVID-19 antibody tests to enter the market 
both in the U.S. and in international markets that will compete against our COVID-19 assays.

In the substance abuse testing market, our Intercept® drug testing system competes with laboratory-based drug testing products using 
sample matrices such as urine, hair, sweat and oral fluid. We expect competition for our products to intensify, particularly from other 
domestic and international companies that have developed, or may develop, competing oral fluid drug testing products. 

There are at least two competitors that sell fully-automated high-throughput oral fluid drug testing products in unregulated settings in 
the United States. These competitors sell these assays for use with either their own oral fluid collector or a collector manufactured by 
another party. These offerings compete against our Intercept® and Intercept i2® collection devices and related oral fluid assays. 

Our MICRO-PLATE oral fluid drug assays, which are sold for use with the original Intercept® collector and our OraSure® collection 
device, also continue to come under increasing competitive pressure from “home-brew” assays developed internally by our laboratory 
customers. Our oral fluid MICRO-PLATE assays also compete with urine-based homogeneous assays that are run on fully-automated, 
random access analyzers. These tests provide strong competitive pressure because they provide the benefits of automation, including 
lower costs and short turn-around times. 

Our MICRO-PLATE drugs-of-abuse reagents sold in the forensic toxicology market are targeted to forensic testing laboratories where 
sensitivity,  automation  and  “system  solutions”  are  important.  We  compete  with  both  homogeneous  and  heterogeneous  tests 
manufactured by many companies. 

Q.E.D.®  competes  against  other  semi-quantitative  saliva-based  alcohol  tests  that  have  received  U.S.  Department  of  Transportation 
approval  as  well  as  breath  alcohol  tests.  Although  there  are  lower  priced  tests  on  the  market  that  use  oral  fluid  or  breath  as a  test 
medium,  these  tests  are  qualitative  tests  that  are  believed  to  be  substantially  lower  in  quality  and  provide  fewer  benefits  than  our 
Q.E.D.® test. 

Molecular Solutions Segment

Our Oragene® and ORAcollect® collection systems compete against other types of collection devices used for molecular testing, such 
as  blood  collection  devices  and  buccal  swabs,  which  often  are  sold  for  prices  lower  than  the  prices  charged  for  the  Oragene®  and 
ORAcollect® products. Although we believe the Oragene® and ORAcollect® devices offer a number of advantages over these other 
products, the availability of lower price competitive devices can result in lost sales and degradation in pricing and profit margin. Our 
Oragene®  and  ORAcollect®  products  are  also  facing  increasing  competition  from  similarly  designed  collection  systems  which  are 
beginning to enter the market. With the receipt of authorizations for use in connection with COVID-19 molecular tests, our Oragene® 
and ORAcollect® products now compete against COVID-19 testing systems and the collection methods used in those systems. 

OMNIgene® • GUT is being sold in the emerging microbiome market and competes with a variety of non-standard in-house solutions 
developed by various researchers, including simply freezing the sample after collection. The microbiome market is expected to require 
standardization in the methods used for collection and stabilization in order to derive more accurate and repeatable results. To date, we 
are one of the few vendors to offer a solution that fully meets these requirements. 

Our genomic and microbiome laboratory service offerings primarily compete against a number of commercial reference laboratories, 
specialty laboratories and hospital laboratories in the U.S.

Patents and Proprietary Information 

We seek patents and other intellectual property rights to protect and preserve our proprietary technology and our right to capitalize on 
the results of our research and development activities. We also rely on trade secrets, know-how, continuing technological innovations 
and  licensing  opportunities  to  provide  competitive  advantages  for  our  products  in  our  markets  and  to  accelerate  new  product 
introductions.  We  regularly  search  for  third-party  patents  in  fields  related  to  our  business  to  shape  our  own  patent  and  product 
commercialization strategies as effectively as possible and to identify licensing opportunities. United States patents generally have a 
maximum term of 20 years from the date an application is filed. 

We have four United States patents and numerous foreign patents for the OraSure® and Intercept® collection devices and technology 
relating to oral fluid collection, containers for oral fluids, methods to test oral fluid, formulations for the manufacture of synthetic oral 
fluid, and methods to control the volume of oral fluid collected and dispersed. The U.S. patents expire from May 2021 to December 
2026.  We  have  also  applied  for  additional  patents,  in  both  the  United  States  and  certain  foreign  countries,  on  such  products  and 
technology. 

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We have one United States patent for our OraQuick® platform expiring in 2028, as well as corresponding related international patents. 
We also have patent applications pending internationally. We have two pending patents in the United States for our COVID-19 Rapid 
Antigen Self-Test and we expect to file additional patent applications for this product in certain international markets.

We  hold,  through  our  subsidiary,  DNAG,  twenty-two  granted  United  States  patents  and  numerous  foreign  patents  issued  for 
compositions, methods and apparatuses for the collection, stabilization, transportation and storage of nucleic acids (DNA and RNA) 
from oral fluid and other bodily fluids and tissues. These patents expire from February 2022 through March 2035.

We  hold  through  our  subsidiary,  Novosanis,  one  granted  United  States  patents  and  numerous  foreign  patents  covering  a  medical 
device for capturing a predetermined volume of first void urine.  This patent expires in September 2033.

Our  subsidiary,  Diversigen,  has  licensed  one  United  States  patent  and  several  foreign  patent  applications  from  the  University  of 
Minnesota for analytical standards to detect and/or measure sampling, processing, and/or amplification errors in a biological samples 
containing  polynucleotide  molecules.    This  license  also  covers  certain  software  and  know-how  related  to  laboratory  and 
bioinformatics procedures and processes.  Diversigen has also licensed certain know-how and database assets from the Baylor College 
of Medicine related to laboratory processes for microbiome and metagenomics services.

We  require  our  employees,  consultants,  outside  collaborators  and  other  advisors  to  execute  confidentiality  agreements  upon  the 
commencement  of  employment  or  consulting  relationships  with  us.  These  agreements  provide  that  all  confidential  information 
developed by or made known to the individual during the course of the individual’s relationship with us is to be kept confidential and 
not disclosed to third parties except in specific circumstances. In the case of employees and certain consultants, the agreements also 
provide  that  all  inventions  conceived  by  the  individual  during  his  or  her  tenure  with  us  or  the  performance  by  the  consultant  of 
services for us will be our exclusive property. 

We own rights to trademarks and service marks that we believe are necessary to conduct our business as currently operated. In the 
United States, we own a number of trademarks, including the OraSure®, Intercept®, Intercept i2®, OraQuick®, OraQuick ADVANCE®,  
OraSure QuickFlu®, Q.E.D.®, Oragene®, DNA GenotekTM, OMNImetTM, ORAcollect®, OMNIgene®, Diversigen®, Colli-Pee®, AUTO-
LYTE®, prepIT® and Hemagene® trademarks. We also own many of these marks and others in several foreign countries and we are 
pursuing registration of several other trademarks. 

Although important, the issuance of a patent or existence of trademark or trade secret protection does not in itself ensure the success of 
our business. Competitors may be able to produce products competing with our patented products without infringing our patent rights. 
Issuance  of  a  patent  in  one  country  generally  does  not  prevent  manufacture  or  sale  of  the  patented  product  in  other  countries. The 
issuance of a patent is not conclusive as to validity or as to the enforceable scope of the patent. The validity or enforceability of a 
patent or trademark can be challenged by litigation after its issuance or registration. If the outcome of such litigation is adverse to the 
owner  of  the  patent,  the  owner’s  rights  could  be  diminished  or  withdrawn.  Trade  secret  protection  does  not  prevent  independent 
discovery and exploitation of the secret product or technique. 

Government Regulation 

General 

Most of our products are regulated by the FDA, along with other federal, state and local agencies and comparable regulatory bodies in 
other countries. This regulated environment governs almost all aspects of development, production and marketing, including product 
design  and  testing,  authorizations  to  market,  labeling,  advertising  and  promotion,  manufacturing,  distribution,  post-market 
surveillance  and  reporting,  and  recordkeeping.  We  believe  that  our  products  and  procedures  are  in  material  compliance  with  all 
applicable  regulations,  but  the  regulations  regarding  the  manufacture  and  sale  of  our  products  may  be  unclear  and  are  subject  to 
change.  We  cannot  predict  the  effect,  if  any,  that  these  changes  might  have  on  our  business,  financial  condition  or  results  of 
operations. 

Many of our FDA-regulated products require some form of review and action by the FDA before they can be marketed in the United 
States.  After  approval  or  clearance  by  the  FDA,  we  must  continue  to  comply  with  other  FDA  requirements  applicable  to  marketed 
products and are subject to periodic inspections by the FDA and other regulatory bodies. Both before and after approval or clearance, 
failure to comply with the FDA’s requirements can lead to significant penalties or could disrupt our ability to manufacture and sell 
these  products.  In  addition,  the  FDA  could  refuse  permission  to  obtain  certificates  needed  to  export  our  products  if  the  agency 
determines that we are not in compliance. 

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Domestic Regulation 

Most of our products are regulated in the United States as in vitro diagnostic and medical devices. In the United States, devices are 
classified into three groups based on risk: class I (lowest risk), class II (moderate risk), and class III (highest risk).  The classification 
of a device determines the level of regulation applicable to the device: class I devices are subject only to the general controls that are 
applicable to all regulated devices; class II devices are subject to both general controls and special controls, which are specific to the 
type  of  device;  and  class  III  devices  are  subject  to  general  controls  and  any  other  controls  that  are  needed  to  provide  reasonable 
assurance of the safety and effectiveness of the specific device.  

The classification of the device also influences the type of premarket submission that is required before the device can be marketed.  
Some  low  risk  devices  (including  many  class  I  and  some  class  II  devices)  may  be  placed  on  the  market  without  any  premarket 
submission.    Such  devices  often  are  referred  to  as  “exempt”  or  “510(k)-exempt.”    Most  devices,  however,  require  some  form  of 
premarket submission prior to marketing.  There are several mechanisms by which such devices can be placed on the market in the 
United States, including 510(k)-clearance, de novo classification, premarket approval, or emergency use authorization. 

Many  class  II  devices  and  some  class  I  devices  may  qualify  for  clearance  under  Section  510(k)  of  the  Federal  Food,  Drug  and 
Cosmetic  Act.  To  obtain  this  clearance  from  the  FDA,  the  manufacturer  must  submit  to  the  FDA  a  premarket  notification  that  it 
intends  to  begin  marketing  the  product,  and  show  that  the  product  is  substantially  equivalent  to  another  legally  marketed  predicate 
device (i.e., a device that has been cleared through the 510(k) process; a device that was legally marketed prior to May 28, 1976; a 
device that has been downclassified by the FDA; or a device that the FDA previously has determined to be exempt from the 510(k) 
process).  To  be  substantially  equivalent,  an  applicant  must  show  that  when  compared  to  a  predicate,  the  new  device  has  the  same 
intended use and same technology, or if different technology, that the new device is as safe and effective as the predicate and does not 
raise different questions of safety and effectiveness. In all cases, data from some form of performance testing is required and in some 
cases, the submission must include data from human clinical studies. An applicant must submit a 510(k) notification at least 90 days 
before commercial distribution of the product commences.  Marketing may only commence when the FDA issues a clearance letter 
finding that the new device is substantially equivalent to the predicate device. The standards and data requirements necessary for the 
clearance of a new device may be unclear or may be subject to change. Although FDA clearance usually takes from four to twelve 
months, in some cases more than a year may be required before clearance is obtained, if at all. 

If  the  device  does  not  qualify  for  the  510(k)  procedure,  either  because  there  is  no  existing  predicate  device,  it  is  not  substantially 
equivalent to a legally marketed predicate device or because it is classified by the FDA as a class III device, the FDA must approve 
either  a  request  for  de  novo  classification  or  a  premarket  approval  application  (“PMA”)  before  marketing  can  begin.  A  de  novo 
classification is an alternate pathway to classify novel devices of low to moderate risk for which no substantially equivalent predicate 
device exists into class I or class II. The FDA’s goal is to decide a de novo request in 150 days from the time the request is received, 
although it can take longer. 

PMAs generally are required for class III devices, i.e., high risk devices, and must demonstrate, among other matters, that the medical 
device provides a reasonable assurance of safety and effectiveness for the intended use(s) of the device. A PMA is typically a complex 
submission,  supported  by  valid  scientific  evidence,  including  the  results  of  preclinical  and  clinical  studies,  usability  data,  detailed 
information about the manufacturing process for the device, and other data and information. Preparing a PMA is a resource-intensive 
and  time-consuming  process.  Once  a  PMA  has  been  submitted,  the  FDA  is  required  to  review  the  submission  within  180  days. 
However, the FDA’s review may be, and often is, much longer, in many cases requiring one to three years or more, and may include 
requests for additional data, review by an independent panel of experts, and facility inspections before approval is granted, if at all. 

If  the  FDA  approves  the  PMA,  it  may  place  restrictions  on  the  device.  If  the  FDA’s  evaluation  of  the  PMA  or  the  manufacturing 
facility is not favorable, the FDA may deny approval of the PMA application or issue a “not approvable” letter. The FDA may also 
require additional clinical trials, which can delay the PMA approval process by several years or prevent a PMA approval from being 
obtained. 

If the FDA discovers that an applicant has submitted false or misleading information in any application or notification, the FDA may 
take action against the applicant and its employees or refuse to review submissions until certain requirements are met pursuant to its 
Application Integrity Policy. Delays in receipt of or failure to receive such clearances or approvals, the loss of previously received 
clearances or approvals, or the failure to comply with existing or future regulatory requirements could have a material adverse effect 
on our business, financial condition and results of operations. 

Another  option  for  marketing  a  product  in  the  U.S.  is  through  an  EUA.    FDA  may  grant  an  EUA  application  for  a  product  if  the 
Secretary  of  Health  and  Human  Services  declares  that  circumstances  exist  justifying  the  authorization  of  emergency  use  of  certain 
products.  Such declaration may be made following a determination by the Secretary of Health and Human Services that there is a 
public health emergency, by the Secretary of Homeland Security that there is a domestic emergency, or by the Secretary of Defense 

16

that there is a military emergency, or the declaration may be made if a material threat is identified under a particular provision of the 
Public  Health  Service  Act.    Typically,  a  diagnostic  device  may  receive  EUA-authorization  on  the  basis  of  analytical  and  clinical 
studies  that  do  not  satisfy  the  requirements  for  clearance  or  approval.  Devices  also  may  be  exempt  from  design  controls  and  other 
quality requirements. An EUA for a device remains in effect until the Secretary of Health and Human Services, in consultation with 
the  Secretary  of  Defense,  determines  that  the  circumstances  justifying  emergency  use  of  the  device  no  longer  exist,  or  until  the 
authorized device is approved or cleared.

If there are any modifications made to our marketed devices, a new premarket notification, PMA supplement, or request to change an 
EUA  may  be  required  to  be  submitted  to,  and  cleared,  approved,  or  authorized  by,  the  FDA,  before  the  modified  device  may  be 
marketed.  A  new  PMA  or  a  PMA  supplement  is  required  for  modifications  that  affect  the  safety  or  effectiveness  of  the  device, 
including, for example, certain types of modifications to the device’s intended use(s), manufacturing process, manufacturing facility, 
critical components, labeling and design. Likewise, a new 510(k) clearance is required for any modification that could significantly 
affect the safety or effectiveness of the device, e.g. a significant change or modification in design, material, chemical composition, 
energy source, or manufacturing process or a major change or modification in the intended use(s) of the device. 

A clinical trial may be required in support of a 510(k) submission and generally is required for a de novo or PMA application. These 
trials  generally  require  an  approved  application  for  an  Investigational  Device  Exemption  (“IDE”)  and  compliance  with  other  IDE 
requirements, unless the proposed study is deemed to be exempt from the IDE requirements. An IDE application must be supported by 
appropriate data, such as laboratory testing results, protocols for the proposed investigation, and other information demonstrating that 
the device is appropriate for use with humans in a clinical study. Clinical trials may begin if the IDE application is approved by the 
FDA  and  the  appropriate  institutional  review  boards  at  the  clinical  trial  sites.  Submission  of  an  IDE  application  does  not  give 
assurance that the FDA will issue the IDE. If the IDE application is approved, there can be no assurance the FDA will determine that 
the data derived from the trial(s) support the ultimate approval or clearance of the device or warrant the continuation of clinical trials. 
An  IDE  supplement  must  be  submitted  to  and  approved  by  the  FDA  before  a  sponsor  or  investigator  may  make  a  change  to  the 
investigational plan in such a way that may affect its scientific soundness, study indication or the rights, safety or welfare of human 
subjects. The trial must also comply with the FDA’s regulations, including the requirement that informed consent be obtained from 
each subject, and with clinical trial reporting regulations that require submission of information on certain clinical trials to a database 
maintained  by  the  National  Institutes  of  Health.  Even  if  a  trial  is  completed,  the  results  of  clinical  testing  may  not  adequately 
demonstrate the safety and efficacy of the device or may otherwise not be sufficient to obtain FDA clearance to market the product in 
the United States. If a study meets the requirements for a non-significant risk study, however, it may be eligible for compliance with 
“abbreviated” IDE requirements, which include a subset of the requirements applicable to significant risk medical device studies.  A 
non-significant  risk  study  also  will  be  considered  to  have  an  approved  IDE  application  without  such  application  actually  being 
submitted to FDA.

Some of our products are used for research only or other nonclinical or non-diagnostic purposes. Our molecular collection products 
are sold to many academic and research institutions for research purposes and our drugs-of-abuse products are sold to laboratories and 
clinics for forensic or other non-medical uses. The FDA does not currently regulate products used for these purposes, although other 
state and federal regulatory requirements may apply. 

Most devices distributed in the United States must comply with the FDA’s Quality System Regulations (“QSRs”), including current 
good  manufacturing  practices.  These  regulations  govern  the  entire  lifecycle  of  a  medical  device,  including  design,  manufacture, 
testing,  release,  packaging,  distribution,  documentation  and  purchasing  as  well  as  complaint  handling,  corrective  and  preventative 
actions, and internal auditing. In complying with the QSRs, manufacturers must continue to expend time, money and effort in the area 
of production, quality, and postmarket surveillance to ensure full compliance. 

Companies  that  market  devices  are  also  subject  to  other  post-market  and  general  requirements,  including  product  listing  and 
establishment  regulations,  which  help  facilitate  FDA  inspections  and  other  regulatory  action,  post-market  surveillance  requests, 
restrictions imposed on marketed products, promotional standards and requirements for recordkeeping and reporting of certain adverse 
reactions and device malfunctions. Device reporting regulations require that manufacturers report if their device may have caused or 
contributed to a death or serious injury, or has malfunctioned in a way that would likely cause or contribute to a death or serious injury 
if the malfunction of the device or a similar device were to recur. 

The FDA regularly inspects companies to determine compliance with the QSRs and other post-market requirements. Failure to comply 
with statutory requirements and the FDA’s regulations can result in an FDA Form 483 (which is issued by the FDA at the conclusion 
of an inspection when an investigator has observed any conditions that may constitute violations), public warning letters, monetary 
penalties against a company or its officers and employees, suspension or withdrawal of regulatory approvals, operating restrictions, 
total or partial suspension of production, injunctions, product recalls, product detentions, refusal to provide export certificates, seizure 
of products and criminal prosecution. We believe that our facilities and procedures are in material compliance with the FDA’s OSR 

17

regulations and other postmarket requirements, but the regulations are subject to change or may be unclear, and we cannot be sure that 
FDA investigators will agree with our compliance with the FDA’s postmarket requirements. 

The  Clinical  Laboratory  Improvement  Amendments  of  1988  (“CLIA”)  prohibit  any  facility  that  conducts  laboratory  testing  on 
specimens derived from humans from providing information for the diagnosis, prevention or treatment of any disease or impairment 
of,  or  the  assessment  of,  the  health  of  human  beings,  unless  there  is  in  effect  for  such  facility  a  certificate  issued  by  the  U.S. 
Department  of  Health  and  Human  Services  or  an  accredited  organization,  and  such  certificate  is  applicable  to  the  category  of 
examination or procedure performed.  Tests may be categorized as “waived,” enabling them to be used by laboratories with the lowest 
level  of  CLIA  oversight  if  the  tests  meet  certain  requirements  established  under  CLIA.  We  consider  the  applicability  of  CLIA 
requirements in the design and development of our products. We have obtained a waiver of the CLIA requirements for our OraQuick 
ADVANCE® rapid HIV-1/2 antibody test, our OraQuick® HCV rapid antibody test and our Q.E.D.® alcohol saliva test and may seek 
similar waivers for certain other products. In addition, the supplier of the OraSure Quick-Flu® test has obtained a CLIA waiver for 
that product. 

The  laboratory  services  provided  by  our  subsidiary,  Diversigen,  are  subject  to  CLIA  and  consist  of  microbiome  and  metagenomics 
sequencing,  bioinformatics  and  analysis.  Diversigen  has  recently  received  a  CLIA  certificate  of  registration  in  Minnesota,  and  is 
pursuing  accreditation  from  the  College  of  American  Pathologists  (CAP).    A  CLIA  certificate  of  compliance  is  issued  once  a  state 
regulator  or  the  Center  for  Medicare  and  Medicaid  Services  determines  that  the  laboratory  is  compliant  with  the  applicable  CLIA 
requirements.  Under CLIA, certain organizations—including CAP—can accredit laboratories performing testing on specimens from 
human beings or animals, using methodologies and clinical applications within the expertise of the laboratory accreditation program.

Certain of our products may also be affected by state regulations in the United States, which can restrict the use and sale of certain 
diagnostic products. We are presently working with legislators or regulators in certain of these states in an effort to modify or remove 
any restrictions affecting our ability to sell products. 

Advertising and Promotion 

Advertising  and  promotion  of  medical  devices,  in  addition  to  being  regulated  by  the  FDA,  are  also  regulated  by  the  Federal  Trade 
Commission  (“FTC”)  and  by  other  federal  and  state  regulatory  and  enforcement  authorities,  including  the  Department  of  Justice 
(“DOJ”),  the  Office  of  Inspector  General  of  the  Department  of  Health  and  Human  Services,  and  various  state  attorneys  general. 
Although  physicians  are  permitted  to  exercise  medical  judgment  to  use  medical  devices  for  indications  other  than  those  cleared or 
approved by the FDA, we may not promote our products for such “off-label” uses and can only market our products for cleared or 
approved  uses.  Promotional  activities  for  FDA-regulated  products  of  other  companies  have  also  been  the  subject  of  enforcement 
actions brought under healthcare reimbursement laws and consumer protection statutes. In addition, under the federal Lanham Act and 
similar  state  laws,  competitors  and  others  can  initiate  litigation  relating  to  advertising  claims.  If  the  FDA  determines  that  our 
promotional materials or training constitute promotion of an uncleared or unapproved use, it could request that we modify our training 
or  promotional  materials  or  subject  us  to  regulatory  or  enforcement  actions,  including  the  issuance  of  an  untitled  letter,  a  notice  of 
violation, a warning letter, injunction, seizure, civil fine or criminal penalties. FTC enforcement actions often result in consent decrees 
that  constrain  future  actions.  DOJ  prosecutions  can  result  in  significant  criminal  and  civil  penalties,  including  exclusion  from  the 
Medicare and Medicaid programs. If an enforcement action is brought by the FDA or FTC, our reputation could be damaged and sales 
of our products could be impaired. 

Import and Export Requirements 

Products for export from the United States are subject to foreign countries’ import requirements and the exporting requirements of the 
FDA, as applicable. In particular, international sales of medical devices manufactured in the United States that are not approved or 
cleared  by  the  FDA  for  use  in  the  United  States,  or  are  banned  or  deviate  from  lawful  performance  standards,  are  subject  to  FDA 
export requirements. 

Foreign countries often require, among other things, an FDA certificate for products for export, also called a Certificate for Foreign 
Government (“CFG”). To obtain this certificate from the FDA, the device manufacturer must apply to the FDA. The FDA certifies 
that the product has been granted clearance or approval in the United States and that the manufacturing facilities were in compliance 
with QSR regulations at the time of the last FDA inspection. If the FDA determines that our facilities or procedures do not comply 
with the QSR regulations, it may refuse to provide such certificates until we resolve the issues to the FDA’s satisfaction. Failure to 
obtain a CFG could inhibit our ability to export our products to countries that require such certificates. 

18

International 

We  are  also  subject  to  regulations  in  foreign  countries  governing  products,  human  clinical  trials  and  marketing,  and  may  need  to 
obtain approval (or pre-qualification or endorsement) from local regulators in such countries or international public health agencies, 
such as the World Health Organization, in order to sell products in certain countries. Approval processes vary from country to country, 
and  the  length  of  time  required  for  approval  or  to  obtain  other  clearances  may  in  some  cases  be  longer  than  that  required  for  U.S. 
governmental approvals. We generally pursue approval only in those countries that we believe have a significant market opportunity. 

The  International  Organization  for  Standardization  (“ISO”)  is  a  worldwide  federation  of  national  standards  bodies  from  some  130 
countries, established in 1947. The mission of the ISO is to promote the development of standardization and related activities in the 
world with a view to facilitating the international exchange of goods and services. ISO 13485 certification indicates that our quality 
system complies with standards applicable to activities ranging from initial product design and development through production and 
distribution. 

In  the  European  Union  (“EU”),  products  that  fall  under  the  scope  of  the  Medical  Devices  Directive  (“MDD”)  and  the  In  Vitro 
Diagnostic Medical Devices Directive (“IVDD”) are not subject to the prior approval of a regulatory authority, but, depending on the 
class of product, may require prior review by a notified body. Notified bodies are accredited and supervised by national regulatory 
authorities  to  conduct  conformity  assessment  procedures  of  medical  devices  or  other  products.  Such  products  must  comply  with 
certain essential requirements listed in those directives. ISO certification creates a rebuttable presumption that the product satisfies the 
applicable requirements. Compliance with these requirements allows us to complete the applicable conformity assessment procedure, 
involving a notified body where necessary, and to affix the CE mark to our products, without which they may not be placed on the 
market in the EU. 

In addition, the EU has adopted the EU Medical Devices Regulation (the “EU MDR”) and the In Vitro Diagnostic Medical Devices 
Regulation  (the  “EU  IVDR”),  which  will  repeal  and  replace  the  MDD  and  IVDD.    The  EU  MDR  and  EU  IVDR  impose  stricter 
requirements for the marketing and sale of medical devices, including in the area of clinical evaluation requirements, quality systems 
and  post-market  surveillance.    Manufacturers  of  currently  approved  medical  devices  will  have  until  May  2021  to  meet  the 
requirements of the EU MDR and until May 2022 to meet the EU IVDR.  Compliance with these regulations may be expensive and 
time-consuming.  Failure to meet these requirements could adversely impact our business in the EU and other regions that tie their 
product registrations to the EU requirements. We also note that from January 1, 2021, the United Kingdom (“UK”) has introduced a 
UK-specific  route  to  market  for  medical  devices.    Compliance  with  these  requirements  may  add  further  complexities  to  our 
international strategy.

We must also comply with certain registration and licensing requirements as dictated by Health Canada, prior to commencing sales in 
Canada. We have completed this process for several of our current products and may do so with respect to other products in the future. 
In  addition,  Canadian  law  requires  manufacturers  of  medical  devices  to  have  a  quality  management  system  that  meets  various  ISO 
requirements in order to obtain a license to sell their devices in Canada. Health Canada also requires all companies that market Class 
II,  Class  III  and  Class  IV  products  in  Canada  to  be  certified  as  part  of  the  Medical  Device  Single  Audit  Program  (MDSAP).    We 
received this certification for our Diagnostics segment (previously named “OSUR”) in June 2019.

We have obtained WHO pre-qualification for our OraQuick® HIV Self-Test and OraQuick® HCV test and we will likely seek WHO 
pre-qualification or endorsement for certain other products sold into international markets. 

Anti-Kickback and Other Fraud and Abuse Laws 

The  Federal  Anti-Kickback  Statute  prohibits  the  knowing  and  willful  offer,  payment,  solicitation,  or  receipt  of  any  form  of 
remuneration in return for, or to induce: 

•

•

The referral of an individual to a person for the furnishing or arranging for the furnishing of items or services reimbursable 
under Medicare, Medicaid or other governmental healthcare programs; or 

The purchase, lease, or order of, or the arrangement or recommendation of the purchasing, leasing, or ordering of any item or 
service reimbursable under Medicare, Medicaid, or other governmental healthcare programs. 

Our  products  are  or  may  be  purchased  by  customers  that  will  seek  or  receive  reimbursement  under  Medicare,  Medicaid  or  other 
governmental  healthcare  programs.  Noncompliance  with  the  Federal  Anti-Kickback  Statute  can  result  in  exclusion  from  Medicare, 
Medicaid or other governmental healthcare programs, and/or restrictions on our ability to operate in certain jurisdictions, as well as 
civil and criminal penalties, any of which could have an adverse effect on our business and results of operations. 

19

The False Claims Act (“FCA”), imposes liability on any person or entity who, among other things, knowingly and willfully presents, 
or causes to be presented, a false or fraudulent claim for payment by a federal health care program, including Medicaid and Medicare. 
A violation of the Federal Anti-Kickback Statute is considered a violation of the FCA.  Some suits filed under the FCA, known as “qui 
tam” actions, can be brought by a “whistleblower” or “relator” on behalf of the government, and such individuals may share in any 
amounts paid by the entity to the government in fines or settlement. Manufacturers can be held liable under false claims laws, even if 
they do not submit

The  Federal  Civil  Monetary  Penalties  Law  prohibits  the  offering  or  transferring  of  remuneration  to  a  Medicare  or  Medicaid 
beneficiary that the person knows or should know is likely to influence the beneficiary’s selection of a particular provider, practitioner 
or  supplier  of  Medicare  or  Medicaid  payable  items  or  services.  Noncompliance  can  result  in  civil  monetary  penalties  for  each 
wrongful  act,  assessment  of  three  times  the  amount  claimed  for  each  item  or  service  and  exclusion  from  the  Federal  healthcare 
programs. 

Many states have also adopted some form of anti-kickback laws and false claims laws. A determination of liability under such laws 
could result in fines and penalties, restrictions on our ability to operate in these jurisdictions and significant damage to our reputation. 

We are also subject to other federal and state laws targeting fraud and abuse in the healthcare industry, including marketing conduct 
laws, transparency laws, and laws that require us to adopt a compliance program. Taken together, these fraud and abuse laws constrain 
the  sales,  marketing  and  other  promotional  activities  of  manufacturers  of  medical  devices  by  limiting  the  kinds  of  financial 
arrangements, including sales programs, such manufacturers can enter into with physicians, hospitals, laboratories and other potential 
purchasers of medical devices. Violations of these laws may be punishable by criminal or civil sanctions, including substantial fines, 
imprisonment and exclusion from participation in government healthcare programs such as Medicare and Medicaid. These laws and 
regulations are wide ranging and subject to changing interpretation and application. In recent years, there has been greater scrutiny of 
marketing  practices  in  the  medical  device  industry  which  has  resulted  in  several  government  investigations  by  various  government 
authorities  and  the  introduction  and/or  passage  of  federal  and  state  legislation  regulating  interactions  between  medical  device 
manufacturers and healthcare professionals and providers and requiring the disclosure by medical device manufacturers of payments 
to certain healthcare providers. For example, under the Sunshine Act provisions of the Affordable Care Act, device manufacturers are 
subject  to  federal  reporting  and  disclosure  requirements  with  regard  to  payments  or  other  transfers  of  value  made  to  health  care 
providers.  Reports  submitted  under  the  Sunshine  Act  are  placed  in  a  public  database.  Device  manufacturers  are  required  to  submit 
annual reports by March 31 which cover the prior calendar year. To be in compliance with such disclosure laws, we have implemented 
necessary systems to accurately track gifts and other payments. 

We have implemented a written Policy on Interactions with Health Care Professionals, which is based on the Code of Conduct for 
Interactions with Health Care Professionals promulgated by the Advanced Medical Technology Association, or AdvaMed, a leading 
trade  association  representing  medical  device  manufacturers.  The  Policy  applies  to  all  employees  and  is  intended  to  comply  with 
applicable  state  and  federal  laws,  regulations  and  government  guidance.  The  Policy  addresses  interactions  related  to  sales  and 
marketing practices, research and development, product training and education, grants and charitable contributions, support of third-
party  educational  conferences,  and  consulting  arrangements.  While  we  believe  that  our  practices  are  in  compliance  with  the  Anti-
Kickback and other fraud and abuse laws, the standards for compliance with such statutes can be unclear and subject to change. 

Foreign Corrupt Practices Act and Other Anti-Corruption Laws 

The U.S. Foreign Corrupt Practices Act (“FCPA”), to which we are subject, prohibits corporations and individuals from engaging in 
bribery and corruption when dealing with foreign government officials and foreign political parties. It is illegal to corruptly offer, pay, 
promise,  or  authorize  the  giving  of  anything  of  value  to  any  officer  or  employee  of  a  foreign  government  or  public  international 
organization, political party, political party official, or political candidate, in an attempt to obtain or retain business or to otherwise 
improperly influence a person working in an official capacity on behalf of a foreign government or public international organization. 
Our  present  and  future  business  has  and  will  continue  to  be  subject  to  the  FCPA  and  various  other  laws,  rules  and/or  regulations 
applicable to us as a result of our international sales. We also are subject to the FCPA’s accounting provisions, which require us to 
keep accurate books and records and to maintain a system of internal accounting controls sufficient to assure management’s control, 
authority, and responsibility over the company's assets. The failure to comply with the FCPA and similar laws could result in civil or 
criminal sanctions or other adverse consequences. 

The laws to which we are subject as a result of our international sales also include the U.K. Bribery Act (the “Bribery Act”), which 
proscribes giving and receiving bribes in the public and private sectors, bribing a foreign public official, and failing to have adequate 
procedures to prevent employees and other agents from giving bribes. U.S. companies that conduct business in the United Kingdom 
generally  will  be  subject  to  the  Bribery  Act.  Penalties  under  the  Bribery  Act  include  potentially  unlimited  fines  for  companies  and 
criminal sanctions for corporate officers under certain circumstances. 

20

Environmental Regulation 

Because of the nature of our current and proposed research, development, and manufacturing processes, we are subject to stringent 
federal, state and local laws, rules, regulations and policies governing the use, generation, manufacture, storage, air emission, effluent 
discharge and handling and disposal of solid wastes, hazardous materials and hazardous wastes. Products that we sell in Europe are 
subject  to  regulation  in  European  Union,  or  EU,  markets  under  the  Directive  on  the  Restriction  of  the  Use  of  Certain  Hazardous 
Substances (“RoHS”). RoHS prohibits companies from selling electrical and electronic equipment, such as electronic medical devices, 
that contain certain hazardous materials, including lead, mercury, cadmium, chromium, polybrominated biphenyls and polybrominated 
diphenyl  ethers,  in  the  EU  Member  States.  In  addition,  the  EU’s  Regulation  on  the  Registration,  Evaluation,  Authorization,  and 
Restriction  of  Chemicals  (“REACH”)  imposes  severe  restrictions  and  requirements  on  companies  marketing  devices  in  the  EU.  
Among other things, REACH requires companies to obtain prior authorization to use substances of very high concern that are listed 
for authorization, and imposes bans on the marketing of products that contain specifically listed hazardous substances.  Companies 
marketing medical devices in the EU may also be subject to expensive waste take back obligations under the EU Directive on Waste 
Electrical and Electronic Directive, the Packaging and Packaging Waste Directive, and the Batteries Directive. 

Future environmental laws, rules, regulations or policies may require us to alter our manufacturing processes, thereby increasing our 
manufacturing  costs,  or  may  impose  other  additional  obligations  on  us  or  our  products.  We  believe  that  our  products  and 
manufacturing processes at our facilities comply in all material respects with applicable environmental laws and worker health and 
safety laws; however, the risk of environmental liabilities cannot be completely eliminated. 

The foregoing discussion of our business should be read in conjunction with the consolidated financial statements and accompanying 
notes included in Item 15 of this Annual Report.

21

 
ITEM 1A. Risk Factors 

Summary of Risk Factors

Below is a summary of the principal factors that could adversely affect our business, operations and financial results. This summary 
does not address all of the risks that we face. Additional discussion of the risks summarized in this summary, and other risks that we 
face, can be found below following this summary. 

Risks Relating to Products, Marketing and Sales 

Changes in the genomics market may adversely affect our business.

•
• Our future success depends upon market acceptance of our existing and future products and service offerings.
• We may not realize anticipated revenue from our COVID-19 diagnostic assays.
•

The COVID-19 pandemic has significantly and adversely affected our consolidated results of operations, financial position 
and cash flows and may continue to do so.

• Marketing  of  our  COVID-19  tests  and  collection  kits  under  EUAs  from  FDA  is  subject  to  certain  limitations  and  we  are 
required to maintain compliance with the terms of the EUA, among other things, and the continuance of the EUAs is subject 
to government discretion.
•
If acceptance and adoption of oral fluid testing and collection products does not continue, our future results may suffer.
• We expect to face increasing competition from other providers of diagnostic tests, sample collection products and molecular 

laboratory services.

• Our product sales cycles can be lengthy and may depend on public funding, which can cause variability and unpredictability 

in our operating results.

• Our inability to expand international sales could adversely affect our business and results of operations.
• Our international presence may increase our risks and expose our business to regulatory, cultural or other restraints.
• Our U.S. government contracts require compliance with numerous laws and increases our risk and liability.
• Our U.S. government contracts may affect our intellectual property rights.
• Our U.S. government contracts and related administrative processes are subject to audits and cost adjustments by the federal 

government.

Risks Relating to Our Industry, Business and Strategy 

Consolidation in the healthcare industry could adversely affect our future revenues and operating results.

•
• Our  research,  development  and  commercialization  efforts  may  not  succeed  and  our  competitors  may  develop  and 

commercialize more effective or successful offerings.

• Acquisitions  or  investments  may  not  generate  the  expected  benefits  and  could  disrupt  our  ongoing  business,  distract  our 

•
•

management, increase our expenses and adversely affect our business.
There are risks relating to our acquisitions of Diversigen, Novosanis and UrSure.
The  future  results  of  acquired  companies  may  be  adversely  impacted  if  we  do  not  effectively  manage  our  expanded 
operations.

Changes in healthcare regulation could affect our revenues, costs and financial condition.

• Our revenues could be affected by third-party reimbursement policies and potential cost constraints.
•
• New or changed testing guidelines could affect sales of our diagnostic products.
•

Reductions in government funding and research budgets could adversely affect our business and financial results.

Risks Relating to Collaborators 

The use of third party supply sources for critical components of our products could adversely affect our business.

•
• Our failure to maintain existing distribution channels, or develop new distribution channels, may result in lower revenues.
• We may need strategic partners to assist in developing and commercializing some of our products.

Risks Relating to Intellectual Property 

• Our success depends on our ability to protect our proprietary technology.
• We may become involved in intellectual property disputes, which could increase our costs and limit or eliminate our ability 

to sell products, provide services or use certain technologies.

22

Regulatory Risks 

•
•

The need to obtain regulatory approvals could increase our costs and adversely affect our financial performance.
Failure to comply with FDA or other regulatory requirements may require us to suspend production or sale of our products or 
institute a recall which could result in higher costs and loss of revenues.

• Our inability to respond to changes in regulatory requirements could adversely affect our business.
• Our  inability  to  manufacture  products  in  accordance  with  applicable  specifications,  performance  standards  or  quality 

requirements could adversely affect our business.

• We  are  subject  to  numerous  government  regulations  in  addition  to  FDA  requirements,  which  could  increase  our  costs  and 

affect our operations.
Failure to comply with privacy, security and breach notification regulations may increase our costs.
Failure to comply with data protection requirements or privacy laws could increase our costs.
FDA regulation of laboratory-develop tests and genetic testing could affect demand for our products.

•
•
•
• Our international sales create potential exposure under anti-corruption laws.

Risks Relating to the Economy, Our Financial Results, Investments, Credit Facilities and Need for Financing 

•

Economic volatility and disruption, including those related to the COVID-19 pandemic could adversely affect our business, 
financial performance, results of operations, cash flow and financial condition or those of our customers and suppliers.

• An impairment of goodwill and intangible assets could reduce our earnings.
• We have experienced losses in the past and may not be able to maintain profitable operations.
•
Changes in foreign currency exchange rates could negatively affect our operating results.

Risks Relating to Our Common Stock

• Our stock price could continue to be volatile.
•

Future sales of our Common Stock by existing stockholders, executive officers or directors could depress the market price of 
our Common Stock and make it more difficult for us to sell stock in the future.
Because we do not intend to pay cash dividends on our Common Stock, an investor in our Common Stock will benefit only if 
our Common Stock appreciates in value.
Certain  provisions  in  our  Certificate  of  Incorporation  and  Bylaws  and  under  Delaware  law  could  make  a  third-party 
acquisition of us difficult.

•

•

General Risk Factors

• We may face product liability claims for injuries resulting from the use of our products.
•
Performance of our products may affect our revenues, stock price and reputation.
• Our ability to sell products could be adversely affected by competition from new and existing products and services.
•
•

Failure to achieve our financial and strategic objectives could have a material adverse impact on our business prospects.
If  we  lose  our  key  personnel  or  are  unable  to  attract  and  retain  qualified  personnel  as  necessary,  our  business  could  be 
harmed.
If our essential employees who are unable to telework become ill or otherwise incapacitated our operations may be adversely 
impacted.
Increases in demand for our products and services could require use to expend considerable resources or harm our customer 
relationships if we are unable to meet that demand. 

•

•

• We rely on information technology in our operations and any material failure, inadequacy, interruption or security breach of 

•

•

that technology could harm our ability to efficiently operate our business.
Security breaches and other disruptions could compromise our information, expose us to liability and harm our reputation and 
business.
Federal and state laws pertaining to healthcare fraud and abuse could adversely affect our business, financial condition and 
results of operations.

• We may experience fluctuations in our financial results or fail to meet our financial projections.
• We may require future additional capital.
•

Terrorist  attacks,  natural  disasters,  public  health  crises  or  other  catastrophic  events  outside  of  our  control  may  adversely 
affect our business.
Future sales of shares of our common stock could adversely affect the trading price of our common stock and our ability to 
raise funds in new equity offerings.

•

23

Risk Factors

You should carefully consider the risks and uncertainties described below, together with all of the other information included in this 
Annual Report and our other SEC filings, in considering our business and prospects. The risks and uncertainties described below are 
not the only ones facing us. Additional risks and uncertainties not disclosed or not presently known to us or that we currently deem 
immaterial also may impair our business operations. The occurrence of any of the following risks could harm our business, financial 
condition or results of operations. 

Risks Relating to Products, Marketing and Sales

Changes in the Genomics Market May Adversely Affect our Business.

The genomics market has been the largest component of our overall molecular business segment for some time and the major driver of 
this market has been ancestry testing which offers products and services to consumers to provide them with genealogical information.  
The ancestry market is maturing and sales to this market have declined in recent periods.  Our genomics revenues have been reduced, 
primarily  due  to  a  change  in  promotional  strategies  and  purchasing  patterns  by  our  largest  customer  which  serves  the  consumer 
ancestry and genetic testing market.  This trend in the ancestry testing market is continuing and is expected to adversely affect our 
revenues and results of operations in future periods.

In an effort to increase our molecular revenues, we have devoted increasing time and attention to expanding sales of our genomics 
products both domestically and internationally, including in the Asia-Pacific and other markets.  While we believe these new markets 
represent large growth opportunities, there is no assurance that we will be successful in capitalizing on these opportunities or that we 
will be able to increase our international product sales consistent with our expectations.  Factors that include, but are not limited to, the 
market acceptance of our products, available funding, cost containment strategies implemented by customers, increasing competition 
and  regulatory  constraints  could  limit  sales  of  our  genomics  products  into  these  international  markets.    To  the  extent  that  we  are 
unsuccessful  or  limited  in  expanding  our  business  in  the  Asia-Pacific  or  other  new  markets,  our  revenues  and  results  of  operations 
could be negatively affected.

Despite  the  challenges  that  we  face  in  the  ancestry  market,  we  believe  there  is  significant  growth  opportunity  for  our  genomics 
products  in  the  area  of  disease  risk  management  (“DRM”).    However,  during  2019,  the  U.S.  Department  of  Justice  (“DOJ”) 
investigated  several  telemedicine  companies  and  individuals  for  allegedly  submitting  fraudulent  insurance  claims  to  Medicare  for 
cancer genetic screening and pharmacogenomics testing.  Several of our customers were included in the DOJ investigation.  These 
activities have had a negative impact on our revenues and to the extent such allegedly fraudulent insurance billing practices continue, 
our future genomic revenues could be adversely affected.

Our Future Success Depends Upon Market Acceptance of Our Existing and Future Products and Service Offerings. 

We believe successful new product and service introductions provide a significant competitive advantage because customers make an 
investment of time in selecting and learning to use a new product or service and are reluctant to switch thereafter. Our future success 
will depend, in part, on the market acceptance, and the timing of such acceptance, of new products such as our in-home antigen pan-
SARS-coronavirus self-test (“Coronavirus Self-Test”), laboratory-based oral fluid SARS-CoV-2 antibody test (“Coronavirus Antibody 
Test”),  OraQuick® HIV  Self-Test,  OraQuick® Ebola  test  and OMNIgene® • GUT  product  offerings,  and  other  new  products  or 
technologies that may be developed or acquired. In addition, our future revenues will depend on market acceptance of new uses for 
our  saliva  collection  products,  including  for  COVID-19  testing,  and  our  new  service  offerings,  such  as  the  microbiome  laboratory 
testing  and  analytical  services  we  provide  through  Diversigen. To  commercially  market  new  uses  of  our  products  and  to  achieve 
market acceptance, we will likely be required to undertake clinical studies to validate the new uses for our products and substantial 
marketing efforts and spend significant funds to complete product development and clinical studies and inform potential customers 
and  the  public  of  the  existence  and  perceived  benefits  of  these  products  and  services.  In  addition,  governmental  funding  may  be 
needed  to  help  complete  development,  obtain  required  regulatory  approvals,  clearances  or  EUAs  and  create  market  acceptance  and 
expand the use of these products and services.

There  may  be  limited  evidence  on  which  to  evaluate  the  market  reaction  to  products  and  services  that  may  be  developed  and  our 
marketing  efforts  for  new  products  and  services  or  products  with  new  uses  may  not  be  successful.  The  market  for  microbiome 
products and services is in its early stages and its future development and acceptance by our customers is uncertain. It is also possible 
that governmental funding may be limited for new products, such as our Coronavirus Self-Test and Coronavirus Antibody Test or the 
new sample collection and stabilization products being commercialized by DNAG. Also, we are still in the process of developing and 
seeking  regulatory  authorization  for  the  Coronavirus  Self-Test  and  Coronavirus  Antibody  Test  and  validating  the  use  of  existing 
products  for  pan-SARS-coronavirus  testing,  and  it  is  uncertain  whether  we  will  be  successful  in  our  development  and  validation 
efforts  or  whether  these  products  will  prove  effective,  receive  applicable  regulatory  approvals,  clearances  or  EUAs  and  gain 

24

widespread  acceptance  in  the  marketplace. As  such,  there  can  be  no  assurance  that  any  products  or  services  will  obtain  significant 
market  acceptance  and  fill  the  market  need  that  is  perceived  to  exist  on  a  timely  basis,  or  at  all.  In  addition,  it  is  possible  that  our 
expenses to develop and market any such products, including, without limitation our Coronavirus Self-Test and Coronavirus Antibody 
Test, will exceed any benefit in revenues, which may be short-lived, or that other products that compete with ours achieve commercial 
acceptable earlier than we do.

We May Not Realize Anticipated Revenue From Our COVID-19 Diagnostic Assays.

We are developing assays to detect antigen and antibodies to the coronavirus, which causes the infectious disease known as COVID-
19.  While we expect to see significant demand for our COVID-19 assays, other companies are working to produce or have produced 
tests  for  COVID-19  which  may  lead  to  the  diversion  of  customers,  including  governmental  and  quasi-governmental  entities,  away 
from us and toward other companies.  Moreover, the dangers posed by COVID-19 may subside over time.  A number of preventative 
vaccines have recently been approved for use in human populations by regulatory agencies in the U.S. and Europe. The anticipated 
effectiveness of these vaccines will likely limit the spread of COVID-19 and potentially reduce the market size for COVID-19 testing.

We  expect  that,  if  and  when  the  current  COVID-19  pandemic  subsides,  there  may  be  a  significantly  reduced  demand  for  ongoing 
testing, and thus, for our COVID-19 assays.  There is no guarantee that current or anticipated demand will continue, or if demand does 
continue, that we will be able to produce our COVID-19 assays in quantities to meet the demand.  A significant decline in demand for 
our COVID-19 assays without a corresponding increase in our other businesses could have a material, adverse effect on our results of 
operations, cash flow and financial position.

The  COVID-19  Pandemic  Has  Significantly  And  Adversely  Affected  Our  Consolidated  Results  of  Operations,  Financial 
Position and Cash Flows, and May Continue To Do So.

Although  we  have  experienced  heavy  demand  for  certain  specimen  collection  devices  for  use  in  COVID-19  molecular  testing  as  a 
result  of  the  COVID-19  pandemic,  which  has  had  a  positive  impact  on  our  performance,  the  duration  and  level  of  the  demand  for 
COVID-19 molecular testing is uncertain.  We believe the COVID-19 pandemic’s adverse impact on its our consolidated results of 
operations, financial position and cash flows will be primarily driven by:  (i) the severity and duration of the COVID-19 pandemic; (ii) 
the COVID-19 pandemic’s impact on the U.S. healthcare system and the U.S. economy; and (iii) the timing, scope and effectiveness 
of  federal,  state  and  local  governmental  responses  to  the  COVID-19  pandemic,  including  the  development  and  deployment  of 
vaccines.

Marketing of Our COVID-19 Tests and Collection Kits Under EUAs From FDA Is Subject To Certain Limitations and We 
Are  Required  To  Maintain  Compliance  With  The  Terms  of  The  EUA,  Among  Other  Things,  And  The  Continuance  of  The 
EUAs Is Subject To Government Discretion.

On February 4, 2020, the U.S. Department of Health and Human Services (“HHS”) issued a declaration that the threat to public health 
posed by COVID-19 justifies the emergency use of unapproved in vitro diagnostics for the detection or diagnosis of SARS-CoV-2. 
Under Section 564 of the Food, Drug, and Cosmetic Act (“FDCA”), because HHS has issued this declaration, the FDA Commissioner 
is  authorized  to  issue  EUAs  to  permit  certain  developers  of  SARS-CoV-2  diagnostics  to  begin  offering  the  tests  for  detection  and 
diagnosis  of  COVID-19  without  having  completed  the  normally  applicable  FDA  review  and  clearance  or  approval  process  for 
marketing authorization (with the related standards that would apply to demonstrate safety and effectiveness). The issuance of an EUA 
reflects an FDA conclusion that based on the totality of scientific evidence available to the FDA, it is reasonable to believe that the 
product  may  be  effective  in  diagnosing  COVID-19,  the  known  potential  benefits  of  the  product  outweigh  the  known  and  potential 
risks, and there is no adequate, approved, and available alternative to the emergency use of the product.

During  2020,  our  ORAcollect®·RNA  and  OMNIgene ®·ORAL  collection  devices  were  included  in  EUAs  granted  by  the  FDA 
to certain  third  parties  for  use  in  the  detection  of  SARS-CoV-2  and  we  have  separately  obtained  EUAs  for  these  products.  Several 
other laboratories are pursuing the inclusion of our specimen collection devices for use with their SARS-CoV-2 assays. In addition, 
we intend to obtain EUAs for our new COVID-19 Rapid Antigen Self-Test and OraSure SARS-CoV-2 antibody ELISA.  Although 
there are certain regulatory requirements the FDA has waived for the duration of the EUAs, we remain subject to specific conditions 
of the authorization, including ensuring appropriate labeling as approved by FDA specifically for purposes of the EUA, maintaining 
records of distribution to authorized laboratories, collecting data on occurrences of any false positives or false negatives, and tracking 
any adverse events.

As with other FDA-regulated products, issues could emerge during the course of the marketing and use of our products under an EUA 
that could impact our ability to continue the sale and distribution of these products (for example, compliance or product performance 
issues).    The  applicable  EUA’s  remain  effective  only  until  the  HHS  declaration  is  terminated  or  revoked,  and  the  FDA  may  also 
revoke an EUA if it determines the criteria for issuance are no longer met or other circumstances make such revocation appropriate to 
protect the public health or safety.  If that were to occur then in order market our diagnostic products or collection kits for the purpose 
of detecting COVID-19, we would be required to obtain the necessary regulatory clearances or approvals and be subject to the full and 
usual regulatory obligations for device manufacturers, including the Quality System Regulation under 21 CFR Part 820. It is possible 

25

that we may not be able to obtain those clearances or approvals in a timely manner, or at all, and that one or more of our competitors 
may obtain the necessary clearances or approvals for their products before we do.

If  Acceptance  and  Adoption  of  Oral  Fluid  Testing  and  Collection  Products  Does  Not  Continue,  Our  Future  Results  May 
Suffer. 

We have made significant progress in gaining acceptance of oral fluid testing products, particularly for (i) HIV testing in the public 
health,  hospital,  insurance  and  other  markets,  and  (ii) drugs-of-abuse  testing  in  the  workplace  and  criminal  justice  markets.  Our 
subsidiary,  DNAG,  has  also  made  significant  progress  in  gaining  acceptance  of  oral  fluid  collection  products  that  are  used  with 
molecular testing applications including testing for SARS-CoV-2. However, the degree of acceptance for these products is uncertain, 
and one or more markets may resist the adoption of oral fluid products as a replacement for other testing or collection methods in use 
today. As a result, there can be no assurance that we will be able to expand the use of our oral fluid testing products in these or other 
markets. 

However,  clinical  reference  laboratories  and  hospital-based  laboratories  currently  provide  the  majority  of  diagnostic  tests  used  by 
physicians and other healthcare providers in the U.S. In certain international markets such as Europe, diagnostic testing is performed 
primarily by centralized laboratories. Our future sales will depend, in part, on our ability to expand market acceptance of rapid point-
of-care testing by physicians, other healthcare providers and consumers and successfully compete against laboratory testing methods 
and products. We expect that clinical reference and other hospital-based laboratories will continue to compete vigorously against our 
rapid  point-of-care  products.  Even  if  we  can  demonstrate  that  our  products  are  more  cost  effective,  save  time,  or  have  better 
performance or other benefits, physicians, other healthcare providers and consumers may resist changing to rapid point-of-care tests 
and instead may choose to obtain diagnostic results through laboratory tests. In addition, demand for our new rapid tests for SARS-
CoV-2 or PrEP adherence may not develop consistent with our expectations. Our failure to achieve and expand market acceptance of 
our rapid point-of-care diagnostic tests with customers would have a negative effect on our future sales growth. 

We  Expect  to  Face  Increasing  Competition  From  Other  Providers  of  Diagnostic  Tests,  Sample  Collection  Products  and 
Molecular Laboratory Services. 

Our rapid point-of-care tests compete with similar point-of-care products made by our competitors. This competition is particularly 
evident  with  respect  to  our  OraQuick  ADVANCE®  HIV-1/2  test  and  our  HIV  Self-Test.    The  Oragene®  product  line  sold  by  our 
subsidiary,  DNAG,  competes  against  other  molecular  collection  products,  such  as  blood  collection  kits  and  buccal  swabs  and  will 
likely face additional competition from collection devices similar in design and operation to our Oragene® and ORACollect® products. 
There are a number of products currently in or expected to enter the market for the detection of antibodies or antigen to SARS-CoV-2 
that will compete with our COVID -19 diagnostic products once completed and authorized for sale.

Our genetic and microbiome laboratory services business is expected to face increasing competition, primarily from large commercial 
reference  laboratories,  hospital-based  laboratories  and  specialty  laboratories.    We  believe  there  is  significant  opportunity  in  the 
markets for these services, particularly the microbiome market which is still in the early stages.  As these markets evolve and expand, 
we expect competition for genomic and microbiome laboratory services to intensify.

There is significant competition, including from other companies and governmental organizations, to create rapid tests for COVID-19. 
Many of these entities have substantially greater resources (including capital and personnel) than we do.  In addition, some of these 
entities  are  or  may  be  further  ahead  in  the  development  and  commercialization  of  tests  than  we  are.  Even  if  we  are  successful  in 
developing and marketing tests for COVID-19, there is no guarantee that competitors will not take market share from our offerings 
through more effective marketing or competitive pricing, higher quality or technological superiority.

A  number  of  our  competitors  are  making  investments  in  competing  technologies,  products  and  services,  and  several  may  have  a 
competitive  advantage  because  of  their  greater  financial,  technical,  research  and  other  resources.  Some  competitors  offer  broader 
product  lines  and  service  offerings,  aggressively  discount  prices  for  their  products  and  services  and  may  have  greater  name 
recognition than we have. We also face competition from certain of our distributors or former customers that have created, or may 
decide  to  create,  their  own  products  to  compete  with  ours.  If  our  competitors  take  market  share  from  our  offerings  through  more 
effective  marketing  or  competitive  pricing,  higher  quality  or  technological  superiority,  our  revenues,  margins  and  operating  results 
could be adversely affected. In addition, our revenues and operating results could be negatively impacted if some of our customers use 
internally developed or acquired sample collection devices or services in order to reduce costs. 

Our  Product  Sales  Cycles  Can  be  Lengthy,  and  May  Depend  on  Public  Funding,  Which  Can  Cause  Variability  and 
Unpredictability in Our Operating Results. 

The  sales  cycles  for  certain  of  our  products  can  be  lengthy  and  unpredictable,  which  makes  it  more  difficult  to  accurately  forecast 
revenues in a given period and may cause revenues and operating results to vary from period to period. Sales of our products often 

26

involve purchasing decisions by large public and private institutions, may require many levels of approval and may be dependent on 
economic or political conditions and the availability of grants or funding from governmental or public health agencies which can vary 
from  period  to  period  in  both  amount  and  timing.  For  example,  in  past  years  our  OraQuick  ADVANCE®  HIV-1/2  test  has  been 
purchased  through  bulk  procurement  or  other  funding  provided  by  governmental  agencies.  Our  OraQuick®  HCV  test  has  been 
purchased by customers who receive government funding, and we believe increased funding from the CDC and other agencies will be 
required to substantially increase the volume of HCV testing, especially in the public health market. We also sold large quantities of 
our  OraQuick®  HCV  test  to  foreign  governments  and  agencies  for  use  in  broad-based  or  country-wide  HCV  elimination  programs. 
There  can  be  no  assurance  that  purchases  or  funding  from  these  agencies  will  occur  or  continue.  As  a  result,  we  may  expend 
considerable resources on unsuccessful sales efforts or we may not be able to complete transactions at all or on a schedule and in an 
amount consistent with our objectives. 

Our Inability To Expand International Sales Could Adversely Affect Our Business and Results of Operations. 

One of our strategic priorities is to substantially expand our product sales internationally. An opportunity to accomplish this objective 
is with the sale of our OraQuick® HIV Self-Test in support of large self-testing programs in certain African countries and elsewhere. 
We are also working to expand international sales of our professional HIV and HCV products and our molecular collection kits.  We 
believe  there  is  a  significant  opportunity  for  international  sales  of  our  SARS-CoV-2  diagnostic  products  once  these  products  are 
available for sale. 

While we believe international sales of these and other products represent attractive long-term opportunities with significant growth 
potential, there is no guarantee that these opportunities will materialize, continue or increase. Among other factors, competition from 
other  cheaper  products  and  the  uncertainties  of  available  funding  could  negatively  impact  the  success  of  these  opportunities.  If 
international  sales  of  these  products  do  not  occur  or  increase  or  if  we  are  otherwise  unable  to  expand  international  sales  of  our 
products, our revenues and results of operations could be negatively impacted. 

In addition, market conditions in many countries often require that we sell our products at a price below our typical U.S. or European 
pricing  in  order  to  participate  in  these  markets.  As  a  result,  sales  in  certain  countries  may  contribute  lower  profit  margins  to  our 
business.  To  the  extent  these  international  sales  comprise  a  large  or  increasing  part  of  our  business,  our  gross  margins  will  be 
negatively  affected.  In  addition,  we  may  have  difficulty  selling  our  products  at  a  sufficiently  low  price  to  maintain  or  increase  this 
business  over  the  long  term  without  funding  support  from  public  health  entities,  government  agencies  or  other  sources.  If  we  are 
unable  to  obtain  or  continue  this  funding  support  at  sufficient  levels,  or  at  all,  our  revenues  and  results  of  operations  could  be 
negatively affected. 

Our International Presence May Increase Our Risks and Expose Our Business to Regulatory, Cultural or Other Restraints. 

We seek to increase revenue derived from international sales of our products. Our international sales accounted for $40.9 million or 
24% of consolidated net revenues in 2020, $47.3 million or 31% of consolidated net revenues in 2019 and $44.9 million or 25% of 
consolidated net revenues in 2018.   In addition, our subsidiary DNAG, which accounted for $97.3 million or 57% of consolidated net 
revenues in 2020, is operated in Canada.  In 2019 we also recently acquired Novosanis, a company based in Belgium, and we may 
acquire other foreign companies as part of our business development efforts.

A  number  of  factors  could  adversely  affect  the  performance  of  our  business  and/or  cause  us  to  incur  substantially  increased  costs 
because of our international presence and sales, including those set forth below: 

• Uncertainty in the application of foreign laws and the interpretation of contracts with foreign parties; 
•

The potential for inconsistent imposition of legal and regulatory requirements; 

•

•

•

•

•

•

•

Cultural  and  political  differences  that  favor  local  competitors  or  make  it  difficult  to  effectively  market,  sell  and  gain 
acceptance of our products; 

Cultural and language differences that make international operations and business management more difficult;

Inexperience in international markets and territories and difficulties in staffing and managing foreign operations; 

Exchange  rates,  currency  fluctuations,  tariffs  and  other  barriers,  extended  payment  terms  and  dependence  on  international 
distributors or representatives; 

Regulatory  requirements,  including  compliance  with  applicable  customs  regulations  and  the  need  to  obtain  or  maintain 
regulatory approvals, registrations or reimbursement approvals for our products; 

Trade protection measures, additional trade sanctions and import/export licensing requirements; 

The inability to obtain or maintain ISO certification for our or our suppliers’ manufacturing facilities; 

27

• Our inability to identify international distributors and negotiate acceptable terms for distribution agreements; 
• Diversion to the U.S. of our products that are sold at lower prices into international markets; 
•

The  loss  of  one  or  more  distributors  and  difficulties  or  delays  in  obtaining  new  or  transferred  product  registrations  or 
approvals for use by a replacement distributor; 

• Multiple jurisdictions and differing tax laws, as well as changes in those laws; 
• An increase of withholding and other taxes on remittances and other payments by a foreign subsidiary; 
•

The creditworthiness of foreign distributors and customers and difficulty in collecting foreign accounts receivable; 

• Difficulty of enforcing contractual obligations or recovering damages under foreign legal systems; 
• Difficulty collecting amounts owed by foreign governments or other customers; 
•

Economic conditions, political instability, the absence of available funding sources, terrorism, civil unrest, war and natural 
disasters in foreign countries; 

•

•

•

•

•

•

•

Exposure to infectious disease and epidemics, including the effects of the coronavirus outbreak on our business operations in 
geographic locations impacted by the outbreak and on the business operations of our customers and suppliers;

Long  sales  cycles  in  international  markets,  especially  for  sales  to  foreign  governments,  quasi-governmental  agencies  and 
international public health agencies; 

The sale of competing products by foreign competitors at prices at or below the prices we offer for our products; 

Restrictions on our ability to repatriate investments and earnings from foreign operations; 

Changes in shipping costs; 

The unavailability of licenses to certain patents in force in a foreign country which cover our products; and 

Reduced protection for, or enforcement of, our patents and other intellectual property rights in foreign countries. 

In  addition,  we  have  contracted  with  a  third  party  in  Thailand  for  the  manufacture  of  a  portion  of  our  OraQuick®  tests,  and  all  of 
DNAG’s products are produced in Canada. We may enter into agreements to manufacture these or other products in additional foreign 
countries as well. However, economic, cultural and political conditions and foreign regulatory requirements may slow or prevent the 
manufacture of our products in countries other than the United States. Interruption of the supply of our products could reduce revenues 
or  cause  us  to  incur  significant  additional  expenses  in  finding  an  alternative  source  of  supply.  Foreign  currency  fluctuations  and 
economic conditions in foreign countries could also increase the costs of manufacturing our products in foreign countries. In addition, 
the  ongoing  coronavirus  pandemic  has  resulted  in  increased  government-imposed  travel  restrictions  and  extended  shutdowns  of 
certain  businesses  in  the  affected  locations.    These  or  any  further  political  or  governmental  responses  to  pandemic  diseases  could 
result in social, economic and labor instability of foreign countries, which could have a material adverse effect on our business, results 
of operations and financial condition.

Our U.S. Government Contracts Require Compliance With Numerous Laws and Increases Our Risk and Liability. 

From time to time, we receive funding from the U.S. government and we sell some of our products to the federal government. As a 
result of our U.S. government funding and product sales to the U.S. government, we must comply with laws and regulations relating to 
the  award,  administration  and  performance  of  U.S.  government  contracts.  U.S.  government  contracts  typically  contain  a  number  of 
extraordinary  provisions  that  would  not  typically  be  found  in  commercial  contracts  and  which  may  create  a  disadvantage  and 
additional risks to us as compared to competitors that do not rely on government contracts. As a U.S. government contractor, we are 
subject to increased risks of investigation, criminal prosecution and other legal actions and liabilities to which purely private sector 
companies are not. The results of any such actions could adversely impact our business and have an adverse effect on our consolidated 
financial performance. 

A violation of specific laws and regulations could result in the imposition of fines and penalties or the termination of our contracts, as 
well  as  suspension  or  debarment.  The  suspension  or  debarment  in  any  particular  case  may  be  limited  to  the  facility,  contract  or 
subsidiary involved in the violation or could be applied to our entire enterprise in certain severe circumstances. Even a narrow scope 
suspension or debarment could result in negative publicity that could adversely affect our ability to renew contracts and to secure new 
contracts, both with the U.S. government and private customers, which could materially and adversely affect our business and results 
of operations. Fines and penalties could be imposed for failing to follow procurement integrity and bidding rules, employing improper 
billing practices or otherwise failing to follow rules relating to billing on cost-plus contracts, receiving or paying kickbacks, or filing 

28

false claims, among other potential violations. In addition, we could suffer serious reputational harm and the value of our common 
stock could be negatively affected if allegations of impropriety related to such contracts are made against us. 

Our U.S. Government Contracts May Affect our Intellectual Property Rights. 

Provisions in our U.S. government contracts may affect our intellectual property rights. Certain of our activities have been funded, and 
may  in  the  future  be  funded,  by  the  U.S.  government,  including  our  contracts  with  the  Biomedical  Advanced  Research  and 
Development Authority (“BARDA”). When new technologies are developed with U.S. government funding, the government obtains 
certain rights in any resulting patents, including the right to a nonexclusive license authorizing the government to use the invention. 
These rights may permit the government to disclose our confidential information to third parties and to exercise “march-in” rights to 
use and allow third parties to use our patented technology. The government can exercise its march-in rights if it determines that action 
is necessary because we fail to achieve practical application of the U.S. government-funded technology, because action is necessary to 
alleviate  health  or  safety  needs,  to  meet  requirements  of  federal  regulations,  or  to  give  preference  to  U.S.  industry.  In  addition, 
government-funded  inventions  must  be  reported  to  the  government,  government  funding  must  be  disclosed  in  any  resulting  patent 
applications, and our rights in such inventions may be subject to certain requirements to manufacture products in the United States. 

Our U.S. Government Contracts and Related Administrative Processes Are Subject to Audits and Cost Adjustments by the 
Federal Government. 

Federal  government  agencies  can  audit  and  investigate  government  contracts  and  the  administrative  processes  and  systems  of 
government contractors. These agencies can review our performance on government contracts, pricing practices, cost structure, and 
compliance with applicable laws, regulations and standards. They can also review our compliance with government regulations and 
policies and the adequacy of our internal control systems and policies, including our purchasing, accounting, estimating, compensation 
and management information processes and systems. Any costs found to be improperly allocated to a specific government contract, 
unallowable  or  unreasonable  will  not  be  reimbursed,  and  any  such  costs  already  reimbursed  may  be  required  to  be  refunded  and 
certain penalties may be imposed. Adjustments arising from government audits and reviews could have a material adverse effect on 
our business, financial condition, results of operations and prospects. 

Moreover, if any administrative process or system related to such contracts is found not to comply with governmental requirements, 
we  may  be  subjected  to  government  scrutiny  that  could  delay  or  otherwise  adversely  affect  our  ability  to  compete  for  or  perform 
government  contracts  or  collect  our  revenue  in  a  timely  manner.  An  unfavorable  outcome  of  an  audit  of  our  government  contracts 
could adversely affect our results of operations.

Risks Relating to Our Industry, Business and Strategy

Consolidation in the Healthcare Industry Could Adversely Affect Our Future Revenues and Operating Results. 

The  healthcare  industry  has  experienced  a  significant  amount  of  consolidation.  As  a  result  of  this  consolidation,  competition  to 
provide  goods  and  services  to  customers  has  increased.  In  addition,  group  purchasing  organizations  and  integrated  health  delivery 
networks  have  served  to  concentrate  purchasing  decisions  for  some  customers,  which  has  also  placed  pricing  pressure  on  medical 
device suppliers. We may not be able to compete successfully in such a consolidated industry. We believe industry consolidation may 
continue as companies attempt to strengthen or hold their market positions and as more companies are acquired or cease operating. 
Further consolidation in the industry could exert additional pressure on the prices of our products. 

Our  Research,  Development  and  Commercialization  Efforts  May  Not  Succeed  and  Our  Competitors  May  Develop  and 
Commercialize More Effective or Successful Offerings. 

In  order  to  remain  competitive,  we  must  regularly  commit  substantial  resources  to  research  and  development  and  the 
commercialization  of  new  or  enhanced  products  and  services.  The  research  and  development  process  generally  takes  a  significant 
amount  of  time  from  inception  to  commercial  launch.  This  process  is  conducted  in  various  stages.  During  each  stage  there  is  a 
substantial risk that we will not achieve our goals on a timely basis, or at all, and we may have to abandon a new or enhanced product 
or service in which we have invested substantial time and money. 

Successful  products  and  services  can  require  significant  development  and  investment,  including  testing  to  demonstrate  their 
performance capabilities, cost-effectiveness or other benefits prior to commercialization. Regulatory approval must be obtained before 
most products may be sold and additional development efforts on these products may be required before any regulatory authority will 
review them. Similarly, regulatory clearances or registrations, such as a CLIA certification, and compliance with industry guidelines, 
may  be  required  in  order  to  provide  competitive  laboratory  services.    As  noted  above,  regulatory  authorities  may  not  issue  such 

29

approvals, clearances or certifications or may substantially delay or condition such action. Even if a product or service is developed 
and  all  applicable  regulatory  approvals,  clearance  or  certifications  are  obtained,  there  may  be  little  or  no  market  for  the  product  or 
service  and  entry  into  or  development  of  new  markets  for  our  products  and  services  may  require  an  investment  of  substantial 
resources, such as new employees, offices and manufacturing facilities. Moreover, we may spend a significant amount of money on 
manufacturing facilities, advertising or other activities and fail to develop a market for the product or service. Other factors that could 
affect the success of our efforts include our ability to manufacture products or provide laboratory services in a cost-effective manner 
and whether we can obtain necessary intellectual property rights and protection in the markets where the product or service is sold. 

Starting in 2020, we have been investing significant time and resources in developing two diagnostic products for SARS-CoV-2 and 
pursuing EUA for these products from the FDA.  If these efforts are successful we believe these products could contribute significant 
revenues once commercialized. We are also investing significantly to expand our manufacturing capacity to ensure we can satisfy the 
expected demand for these products.

If we fail to develop and gain commercial acceptance for our products and services, or if competitors develop more effective products 
and  services  or  a  greater  number  of  successful  new  products  and  services,  customers  may  decide  not  to  purchase  our  products  and 
services or may purchase and use products and services developed by our competitors. This would result in a loss of revenues and 
adversely  affect  our  results  of  operations,  cash  flow  and  business.    Additionally,  if  we  are  not  successful  in  commercializing  our 
planned SARS-CoV-2 assays, the investment in expanded manufacturing capacity may not be fully utilized.

Acquisitions or Investments May Not Generate the Expected Benefits and Could Disrupt Our Ongoing Business, Distract Our 
Management, Increase Our Expenses and Adversely Affect Our Business. 

Since the beginning of 2019, we have acquired several companies through which we have gained access to new technologies, products 
and  services  which  are  complementary  to  our  existing  business  and  aligned  with  our  long-term  business  strategy.    We  will  likely 
continue  to  pursue  strategic  acquisitions  or  investments  as  a  way  to  expand  our  business.  These  activities,  and  their  impact  on  our 
business, are subject to many risks, including the following: 

•

Suitable acquisitions or investments may not be found or consummated on terms or schedules that are satisfactory to us or 
consistent with our objectives; 

• We may be unsuccessful in competing for acquisitions with other entities, some of which have greater financial resources or 

may be better able to realize synergies with a potential target; 

•

The  benefits  expected  to  be  derived  from  an  acquisition  or  investment  may  not  materialize  and  could  be  affected  by 
numerous  factors,  such  as  regulatory  developments,  insurance  reimbursement,  our  inexperience  with  new  businesses  or 
markets, general economic conditions and increased competition; 

• We may be unable to successfully integrate an acquired company’s personnel, assets, management, information technology 

systems, accounting policies and practices, products, services and/or technology into our business; 

• Worse than expected performance of an acquired business may result in the impairment of intangible assets; 
• Acquisitions may require substantial expense and management time and could disrupt our business; 
• We may not be able to accurately forecast the performance or ultimate impact of an acquired business; 
• We may have difficulties in coordinating geographically separate organizations; 
• We may fail to successfully manage relationships with customers, distributors and suppliers of an acquired business; 
• An acquisition may result in a diversion of resources from our existing products, business and technologies; 
• An  acquisition  and  subsequent  integration  activities  may  require  greater  capital  and  other  resources  than  originally 

anticipated at the time of acquisition; 

•

To  the  extent  we  agree  to  pay  contingent  consideration  for  an  acquisition,  if  and  how  much  of  such  consideration  we  are 
required to pay may be subject to dispute, resulting in the distraction of our management team and the incurrence of legal 
costs;

• An acquisition may result in employee anxiety, morale and/or engagement issues;
• An  acquisition  may  result  in  disparate  information  technology,  internal  control,  financial  reporting  and  record-keeping 

systems;

• An acquisition may result in new partners or customers who may operate on terms and programs different than ours;

30

• An acquisition may result in employees not familiar with our operations;
• An acquisition may result in new products and services, including the risk that any underlying intellectual property associated 
with such products and services may not have been adequately protected or that such products and services may infringe on 
the proprietary rights of others;

• An acquisition may result in the incurrence of unexpected expenses, stockholder lawsuits, the dilution of our earnings or our 
existing  stockholders’  percentage  ownership,  or  potential  losses  from  undiscovered  liabilities  not  covered  by  an 
indemnification from the seller(s) of the acquired business; 

• An acquisition may result in the loss of our or the acquired company’s key personnel, customers, distributors or suppliers; 

and 

• An acquisition of a foreign business may involve additional risks, including, but not limited to, foreign currency exposure, 
liability  or  restrictions  under  foreign  laws  or  regulations,  and  our  inability  to  successfully  assimilate  differences  in  foreign 
business  practices  or  overcome  language  or  cultural  barriers  and  other  inherent  risks  of  operating  in  unfamiliar  legal  and 
regulatory environments. 

The occurrence of one or more of the above or other factors may prevent us from achieving all or a significant part of the benefits 
expected from an acquisition or investment. This may adversely affect our financial condition, results of operations and ability to grow 
our business or otherwise achieve our financial and strategic objectives. 

There Are Risks Relating To Our Acquisitions of Diversigen, Novosanis and UrSure.

The  success  of  the  acquisitions  will  depend,  in  part,  on  our  ability  to  successfully  combine  and  integrate  our  legacy  business  with 
those businesses.  The integration of the businesses with our existing business can be complex, costly and time-consuming processes.  
It is possible that a number of factors, including, without limitation, the loss of key employees, higher than expected costs, diversion 
of management attention and resources, the disruptions of ongoing businesses or inconsistencies in standards, controls, procedures and 
policies,  could  adversely  affect  our  ability  to  maintain  relationships  with  customers,  vendors  and  employees  or  to  achieve  the 
anticipated  benefits  and  cost  savings  of  the  acquisitions.    If  we  experience  difficulties  with  the  integration  process,  the  anticipated 
benefits of the acquisitions may not be realized fully or at all, or may take longer to realize than expected.  These integration matters 
could have an adverse effect on the Company for an undetermined period following the acquisitions.

As a general matter, the market for microbiome laboratory testing and analytical services provided by CoreBiome and Diversigen is at 
an early stage and is still developing.  In addition, the Colli-Pee® urine collection devices manufactured and sold by Novosanis are 
relatively new products that are not yet widely accepted by customers.  Although we are optimistic about the prospects for these new 
businesses, there is no assurance that we will be successful in creating or expanding demand for these services and products.  To the 
extent  that  the  markets  for  these  services  and  products  fail  to  develop  or  increase,  our  revenues  and  results  of  operations  could  be 
adversely affected and we may not meet our growth objectives.

The  Future  results  of  Acquired  Companies  May  Be  Adversely  Impacted  if  We  Do  Not  Effectively  Manage  Our  Expanded 
Operations.

Following the completion of recent acquisitions, the size of our business has increased and these acquisitions are expected to enhance 
our  growth  in  future  periods.    Our  ability  to  successfully  manage  this  expanded  business  will  depend,  in  part,  upon  management’s 
ability to design and implement strategic initiatives that address not only the integration of the two companies, but also the increased 
scale and scope of the combined businesses with its associated increased costs and complexity.  There can be no assurances that we 
will be successful and the acquisitions may have an adverse effect on the Company.

Our Revenues Could be Affected by Third-Party Reimbursement Policies and Potential Cost Constraints. 

The end-users of certain of our products include hospitals, physicians and other healthcare providers. Use of our products could be 
adversely  impacted  if  these  end-users  do  not  receive  adequate  reimbursement  for  the  cost  of  our  products  from  their  patients’ 
healthcare insurers or payors. Our net sales could also be adversely affected by changes in reimbursement policies of governmental or 
private healthcare payors, including in particular the level of reimbursement for our products. 

In the United States, hospitals, physicians and other healthcare providers who purchase diagnostic products generally rely on third-
party payors, such as private health insurance plans, Medicare and Medicaid, to reimburse all or part of the cost of the product and 
procedure. The overall escalating cost of medical products and services has led to, and will continue to lead to, increased pressures on 
the healthcare industry, both foreign and domestic, to reduce the cost of products and services. Given the efforts to control and reduce 
healthcare costs in the United States in recent years, currently available levels of reimbursement may not continue to be available in 
the future for our existing products or products under development. Third-party reimbursement and coverage may not be available or 

31

adequate  in  either  the  United  States  or  international  markets,  current  reimbursement  amounts  may  be  decreased  in  the  future  and 
future  legislation,  and  regulation  or  reimbursement  policies  of  third-party  payors,  may  reduce  the  demand  for  our  products  or  our 
ability to sell our products on a profitable basis.  In addition, the reimbursement approval process may delay the market introduction 
of our products.

Changes in Healthcare Regulation Could Affect Our Revenues, Costs and Financial Condition. 

In recent years, there have been numerous initiatives at the federal and state level for comprehensive reforms affecting the payment 
for, the availability of and reimbursement for healthcare services in the United States. These initiatives have ranged from proposals to 
fundamentally change federal and state healthcare reimbursement programs, including providing comprehensive healthcare coverage 
to the public under government-funded programs, to minor modifications to existing programs. One example is the Patient Protection 
and Affordable Care Act, the Federal healthcare reform law enacted in 2010 (the “Affordable Care Act”). Similar reforms may occur 
internationally. 

Legislative  and  regulatory  bodies  are  likely  to  continue  to  pursue  healthcare  reform  initiatives  in  many  forms  and  may  continue  to 
reduce  funding  in  an  effort  to  lower  overall  federal  healthcare  spending.  The  U.S.  government  recently  enacted  legislation  that 
eliminated what is known as the “individual mandate” under the Affordable Care Act and may enact other changes in the future. The 
ultimate content and timing of any of these types of changes in other healthcare reform legislation and the resulting impact on us are 
impossible  to  predict.  If  significant  reforms  are  made  to  the  healthcare  system  in  the  United  States,  or  in  other  jurisdictions,  those 
reforms may increase our costs or otherwise have an adverse effect on our financial condition and results of operations. 

New or Changed Testing Guidelines Could Affect Sales of Our Diagnostic Products. 

From time to time, governmental agencies such as the Centers for Disease Control and Prevention, or CDC, issue diagnostic testing 
guidelines  or  recommendations,  which  can  affect  the  usage  of  our  HIV  and  HCV  tests  or  other  diagnostic  products.  For  example, 
domestic  professional  OraQuick®  HIV  sales  have  decreased  in  part  due  to  customer  migration  to  automated  fourth  generation  HIV 
immunoassays performed in a laboratory, as recommended under testing guidelines issued by the CDC. In addition, some states have 
promulgated,  or  may  in  the  future  promulgate,  laws  and  regulations  that  affect  HIV  or  HCV  testing.  The  issuance  of  new  laws  or 
guidelines,  or  changes  in  existing  laws  or  guidelines,  and  the  manner  in  which  these  new  or  changed  laws  and  guidelines  are 
interpreted  and  applied  by  healthcare  practitioners,  could  impact  the  degree  to  which  our  OraQuick®  rapid  HIV  and  HCV  testing 
products or other products are used. New or changed laws or guidelines could affect the number of people tested, the frequency of 
testing and whether testing products such as our OraQuick® HIV and HCV tests are used broadly for screening large populations or in 
a more limited capacity as a confirmatory test or otherwise. These factors could in turn affect the level of sales of our products and our 
results of operations. 

Reductions in Government Funding and Research Budgets Could Adversely Affect Our Business and Financial Results. 

We sell our OraQuick ADVANCE® HIV-1/2 and OraQuick® HCV tests into the public health market which consists of state, county 
and  other  governmental  public  health  agencies,  community  based  organizations,  service  organizations  and  similar  entities.  We  also 
sell these products into the hospital market. Many of these customers depend to a significant degree on grants or funding provided by 
governmental  agencies  to  run  their  operations  including  programs  that  use  our  products.  In  international  markets,  we  often  sell 
products such as our OraQuick® HIV Self-Test to or through foreign governmental agencies or parties funded by such agencies. 

Many  of  our  molecular  collection  products  are  sold  to  researchers  at  academic  institutions,  pharmaceutical  and  biotechnology 
companies, government laboratories and private foundations. Many research customers are dependent for their funding on grants from 
U.S. governmental agencies such as the U.S. National Institutes of Health and agencies in other countries to pay for the products and 
services they purchase.  These research customers also purchase our genomic and microbiome laboratory tests and analytical services. 

The level of available government grants or funding in the U.S. and elsewhere is unpredictable and may be affected by various factors 
including  economic  conditions,  legislative  and  regulatory  developments,  political  changes,  civil  unrest  and  changing  priorities  for 
research and development activities. Further, government proposals to reduce or eliminate budgetary deficits have sometimes included 
reduced allocations to government agencies in the U.S. and other countries that fund life sciences research and development activities.  
Any reduction or delay in government or other funding as a result of legislative or regulatory changes or other factors, could cause our 
customers to delay, reduce or forego purchases of our products and services. 

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Risks Relating to Collaborators

The Use of Third Party Supply Sources For Critical Components of Our Products Could Adversely Affect Our Business. 

We  currently  purchase  certain  critical  components  of  our  products  from  sole  supply  sources  or  other  third-party  suppliers.  For 
example, the biological antigens and antibodies, nitrocellulose and certain other components required to make our OraQuick® HIV, 
HCV  and  Ebola  products  are  currently  purchased  from  sole  source  suppliers.  Our  OraSure  QuickFlu® test  and  the  fully  automated 
high-throughput  drug  assays  sold  with  our  Intercept  i2® device  are  manufactured  and  supplied  by  sole  source  suppliers  and  the 
conjugates used in our MICROPLATE oral fluid drugs-of-abuse assays are obtained from third-party suppliers. We have contracted 
with a third party in Thailand for the assembly of OraQuick® HIV device and the OraQuick® HIV Self-Test in order to supply certain 
international markets. In addition, our subsidiary, DNAG, uses three third-party manufacturers to supply virtually all of its products, 
including its Oragene® and ORAcollect® lines of collection kits. Many of the raw materials and components used in its products are 
also purchased from third parties, a critical one of which is obtained from a sole source supplier.

The COVID-19 pandemic and the measures taken to contain the spread of the virus, could disrupt the normal operations of our third-
party  suppliers. Our  third-party  suppliers  may  not  have  the  personnel,  raw  materials,  capacity  or  capability  to  manufacture  our 
products  according  to  our  schedule  and  specifications. To  the  extent  any  such  production  and  distribution  interruption  or  closures 
occur and continue for an extended period of time, the impact on our supply chain could have a material adverse effect on our results 
of operations. If our third-party suppliers are unable or unwilling to supply or manufacture a required component or product or if they 
make changes to a component, product or manufacturing process or do not supply materials meeting our specifications, we may need 
to find another source and/or manufacturer. This could require that we perform additional development work and it may be difficult to 
find such an alternate supply source in a reasonable time period or on commercially reasonable terms, if at all. We may also need to 
obtain  FDA  or  other  regulatory  approvals  for  the  use  of  an  alternative  component  or  for  changes  to  our  products  or  manufacturing 
process. Completing that development and obtaining such approvals could require significant time and expense and such approvals 
may not occur at all. The availability of critical components and products from sole supply sources or other third parties could also 
reduce  our  control  over  pricing,  quality  and  timely  delivery.  These  events  could  either  disrupt  our  ability  to  manufacture  and  sell 
certain of our products into one or more markets or completely prevent us from doing so, and could increase our costs. Any such event 
could have a material adverse effect on our results of operations, cash flow and business.

Our  Failure  to  Maintain  Existing  Distribution  Channels,  or  Develop  New  Distribution  Channels,  May  Result  in  Lower 
Revenues. 

We have marketed many of our products by collaborating with laboratories, diagnostic companies and distributors. Our sales depend 
to  a  substantial  degree  on  our  ability  to  sell  products  to  these  customers  and  on  the  marketing  and  distribution  abilities  of  the 
companies with which we collaborate. 

Relying on distributors or others to market and sell our products could harm our business for various reasons, including: 
• We may not be able to find suitable distributors to distribute our products on satisfactory terms, or at all; 
• Our distributors or other customers may not fulfill their contractual obligations to us or otherwise market and distribute our 

products in the manner or at the levels we expect; 

• We do not control the incentives provided by our distributors to their sales personnel and the effectiveness of these incentives 

could affect sales of our products; 

• Agreements with distributors may terminate prematurely due to disagreements or may result in litigation between the parties; 
• We may not be able to renew existing distribution agreements on acceptable terms, or at all; 
• Our distributors may not devote sufficient resources or priority to the sale of our products; 
• Our distributors may prioritize their own private label products that compete with our products; 
• Our  existing  distributor  relationships  or  contracts  may  preclude  or  limit  us  from  entering  into  arrangements  with  other 

distributors; and 

• We may not be able to negotiate future distribution agreements on acceptable terms, or at all. 

Although we will try to maintain and expand our business with distributors and customers and require that they fulfill their contractual 
obligations,  there  can  be  no  assurance  that  such  companies  will  do  so  or  that  new  distribution  channels  will  be  available  on 
satisfactory terms. As a result, our revenues and business could be adversely affected. 

33

We May Need Strategic Partners to Assist in Developing and Commercializing Some of Our Products. 

Although we may elect to pursue some product opportunities independently, opportunities that require a technology controlled by a 
third  party,  a  significant  level  of  investment  for  development  and  commercialization  or  a  distribution  network  beyond  our  existing 
sales  force  may  necessitate  involving  one  or  more  strategic  partners.  Further,  our  ability  to  enter  into  agreements  with  additional 
strategic partners depends in part on convincing them that our products can help achieve and accelerate their goals and efforts.  Our 
strategy for development and commercialization of products may entail entering into arrangements with distributors or other corporate 
parties, universities, research laboratories, government agencies, licensees and others. Relying on collaborative relationships could be 
risky to our business for a number of reasons, including: 

• We may be required to transfer material rights to such strategic collaborators, government agencies, licensees and others; 
• Our collaborators may not devote sufficient resources or attach a sufficiently high priority to the success of our collaboration; 
• Our collaborators may not obtain regulatory approvals necessary to continue the collaborations in a timely manner; 
• We have limited access to our collaborator’s confidential corporate information and sudden unexpected changes in ownership 
or strategy or other material events affecting a collaborator of which we are not made aware of in a timely manner, or at all, 
could adversely impact our relationship;

• Our collaborators may be acquired by another company, sell the part of their business related to our collaboration, decide to 

terminate our collaborative arrangement or become insolvent; 

• Our collaborators may develop technologies or components competitive with our products; 
• Our collaborators may fail to deliver technologies or components that satisfy market requirements or such products may fail 

to perform properly; 

• Disagreements with collaborators could result in the termination of the relationship or litigation; 
•

Collaborators may not have sufficient capital resources; and 

• We  may  not  be  able  to  negotiate  future  collaborative  arrangements,  or  renewals  of  existing  collaborative  agreements,  on 

acceptable terms or at all. 

While we generally expect that our collaborative partners will have an economic motivation to succeed in performing their contractual 
responsibilities, there is no assurance that they will do so, either at the level required or at all, and the amount and timing of resources 
to be devoted to these activities will be controlled by others. Reliance on strategic agreements can also make it difficult to accurately 
forecast our future revenues or operating results. There can be no assurance that the expected revenues or profits will be fully derived 
from such arrangements. 

Risks Relating to Intellectual Property

Our Success Depends on Our Ability to Protect Our Proprietary Technology. 

Our industry places considerable importance on obtaining patent, trademark and trade secret protection, as well as other intellectual 
property rights, for new technologies, products and processes. Our success depends, in part, on our ability to develop and maintain a 
strong intellectual property portfolio or obtain licenses to patents and technologies, both in the United States and in other countries. If 
we cannot continue to develop, obtain and protect intellectual property rights, our revenues and profits could be adversely affected. 
Moreover, our current and future licenses or other rights to patents and other technologies may not be adequate for the operation of 
our business. 

As  appropriate,  we  intend  to  file  patent  applications  and  obtain  patent  protection  for  our  proprietary  technology.  These  patent 
applications  and  patents  will  cover,  as  applicable,  compositions  of  matter  for  our  products,  methods  of  making  those  products, 
methods of using those products and apparatuses relating to the use or manufacture of those products. 

We also rely on trade secrets, know-how and continuing technological advancements to protect our proprietary technology. We have 
entered, and will continue to enter, into confidentiality agreements with our employees, consultants, advisors and collaborators. Our 
employees  and  third-party  consultants  also  sign  agreements  requiring  that  they  assign  to  us  interests  in  inventions  and  original 
expressions and any patents or copyrights arising from their work. However, these parties may not honor these agreements. 

We  cannot  guarantee  that  the  process  of  filing  patents,  the  laws  governing  trade  secrets  and  proprietary  information,  or  any 
agreements we enter into with employees, consultants, advisors or collaborators will provide adequate protection of our intellectual 

34

 
property  rights.  For  example,  our  competitors  may  develop  similar  products  without  infringing  on  any  of  our  intellectual  property 
rights or design around our proprietary technologies.  Employees, consultants and others who participate in the development of our 
products  may  breach  their  agreements  with  us  regarding  our  intellectual  property,  and  we  may  not  have  adequate  remedies  for  the 
breach. We also may not be able to effectively protect our intellectual property rights in some foreign countries, as many countries do 
not offer the same level of legal protection for intellectual property as the United States. 

For a variety of reasons, we may decide not to file for patent, copyright or trademark protection outside of the U.S. Our trade secrets 
could  become  known  through  other  unforeseen  means.  Although  we  have  licensed  certain  technology  for  use  in  our  microbiome 
laboratory services offerings and we have developed proprietary know-how that we use in this business, we do not currently hold any 
patents covering the laboratory processes and analytical methods offered to our customers.  The absence of patent protection in this or 
other  parts  of  our  business  may  make  it  more  difficult  to  protect  our  intellectual  property.    In  addition,  our  competitors  may 
independently develop similar or alternative technologies or products that are equal or superior to our technology. 

Moreover,  issued  patents  remain  in  effect  for  a  fixed  period  and  after  expiration  will  not  provide  protection  of  the  inventions  they 
cover. Once our patents expire, we may be faced with increased competition, which could reduce our revenues. We may also not be 
able to successfully protect our rights to unpatented trade secrets and know-how. 

Some  of  our  employees,  including  scientific  and  management  personnel,  were  previously  employed  by  competing  companies. 
Although we encourage and expect all of our employees to abide by any confidentiality agreement with a prior employer, competing 
companies may allege trade secret violations and similar claims against us. In addition, some of these agreements may conflict with, 
or be subject to, the rights of third parties with whom our employees, consultants or advisers have prior employment or consulting 
relationships. An adverse determination may limit or restrict the type of work that certain employees involved with such products may 
perform.

We may collaborate with universities and governmental research organizations or receive funding for our products from government 
agencies.  As a result, one or more of these entities may acquire part of the rights to any inventions or technical information derived 
from our collaboration or funding relationship with them. 

To facilitate development and commercialization of a proprietary technology base, we may need to obtain licenses to patents or other 
proprietary  rights  from  other  parties.  Obtaining  and  maintaining  such  licenses  may  require  the  payment  of  substantial  amounts.  In 
addition, if we are unable to obtain these types of licenses, our product development and commercialization efforts may be delayed or 
precluded.  Moreover,  some  licenses  may  be  nonexclusive,  and  therefore  our  competitors  may  have  access  to  the  same  technology 
licensed to us.

We  May  Become  Involved  in  Intellectual  Property  Disputes,  Which  Could  Increase  our  Costs  and  Limit  or  Eliminate  Our 
Ability to Sell Products, Provide Services or Use Certain Technologies. 

From time to time, we may seek to enforce our patents or other intellectual property rights through litigation. In addition, there are a 
large number of patents and patent applications in our product and service areas, and additional patents may be issued to third parties 
relating  to  our  product  and  service  areas.  We,  our  customers  or  our  suppliers  may  be  sued  for  infringement  of  patents  or 
misappropriation of other intellectual property rights with respect to one or more of our products or services. Litigation in our industry 
regarding patent and other intellectual property rights is prevalent and is expected to continue. We may also have disputes with parties 
that license patents to us if we believe the license is no longer needed for our products or services or the licensed patents are no longer 
valid or enforceable. 

Our  industry  is  characterized  by  a  large  number  of  patents,  and  the  claims  of  these  patents  appear  to  overlap  in  many  cases.  As  a 
result, there is a significant amount of uncertainty regarding the extent of patent protection and infringement. Companies may have 
pending patent applications, which are typically confidential for the first eighteen months following filing, that cover technologies we 
incorporate in our products or services. Accordingly, we may be subjected to substantial damages for past infringement or be required 
to  modify  our  products  or  services  or  stop  selling  them  if  it  is  ultimately  determined  that  our  products  or  services  infringe  a  third 
party’s  proprietary  rights.  In  addition,  governmental  agencies  could  commence  investigations  or  criminal  proceedings  against  our 
employees or us relating to claims of misuse or misappropriation of another party’s proprietary rights. 

Intellectual property litigation is costly. As such, our involvement in litigation or other legal proceedings with respect to patents or 
other intellectual property and proprietary technology, either as a plaintiff or defendant, could adversely affect our revenues, market 
share, results of operations and business because: 

• As is common with major litigation, it could consume a substantial portion of managerial and financial resources; 

35

•

Its outcome would be uncertain and a court may find that our patents are invalid or unenforceable in response to claims by 
another party or that the third-party patent claims are valid and infringed by our products or services; 

• An  adverse  outcome  could  subject  us  to  the  loss  of  the  protection  of  our  patents  or  to  liability  in  the  form  of  past  royalty 
payments,  penalties,  reimbursement  of  litigation  costs  and  legal  fees,  special  and  punitive  damages,  or  future  royalty 
payments, any of which could significantly affect our future earnings; 

• Governmental agencies may commence investigations or criminal proceedings against our employees, former employees and 

us relating to claims of misappropriation or misuse of another party’s proprietary rights; 

•

Failure to obtain a necessary license upon an adverse outcome could prevent us from selling our current products or services  
or other products or services we may develop or acquire; 

• We may be required to alter our product or services, given the proprietary rights of others; 
•

The pendency of any litigation may in and of itself cause our distributors and customers to reduce or terminate purchases of 
our products or services; and 

• A court could award a preliminary and/or permanent injunction, which would prevent us from selling our current or future 

products or services. 

We may indemnify some customers and strategic partners under our agreements with such parties if our products, services or activities 
have  actually  or  allegedly  infringed  upon,  misappropriated  or  misused  another  party’s  proprietary  rights.  Further,  our  products  or 
services  may  contain  technology  provided  to  us  by  other  parties,  such  as  universities,  contractors,  suppliers,  customers  or 
collaborators, and we may have little or no ability to determine in advance whether such technology infringes the intellectual property 
rights  of  a  third  party.  These  other  parties  may  also  not  be  required  or  financially  able  to  indemnify  us  in  the  event  that  an 
infringement or misappropriation claim is asserted against us. 

We may also become involved in other types of disputes regarding intellectual property rights, including state, federal or foreign court 
litigation,  and  patent  interference,  patent  reexamination,  patent  reissue,  or  trademark  opposition  proceedings  in  the  United  States 
Patent  and  Trademark  Office.  Opposition  or  revocation  proceedings  could  be  instituted  in  a  foreign  patent  office  as  well.  Under 
Federal law, various forms of post issuance patent review proceedings have been authorized, including an inter-parties review process. 
These proceedings permit certain persons to challenge the validity of a patent on the grounds that it was known from the prior art. The 
filing of such proceedings, or the issuance of an adverse decision in such proceedings, could result in the loss of valuable patent rights 
that could have a material adverse effect on our business, financial condition, results of operations and growth prospects. 

Regulatory Risks

The Need to Obtain Regulatory Approvals Could Increase Our Costs and Adversely Affect Our Financial Performance. 

Many  of  our  proposed  and  existing  products  and  services  are  subject  to  regulation  by  the  FDA  and  other  governmental  or  public 
health agencies. In particular, we are subject to strict governmental controls on the development, manufacture, labeling, distribution 
and marketing of our products and the processes and procedure for our laboratory services.   Our practice is to train our employees on 
the legal requirements applicable to our business, including the requirements of the FDA and other relevant agencies.

The process of obtaining required approvals, clearances, premarket authorizations can involve lengthy and detailed laboratory testing, 
human clinical trials, sampling activities and other costly, time-consuming procedures. These approvals, clearances, other premarket 
authorizations or certifications can require the submission of a large amount of clinical data which can be expensive and may require 
significant time to obtain. It is also possible that a product will not perform at a level needed to generate the clinical data required to 
obtain such premarket authorizations. The submission of an application to the FDA or other regulatory authority does not guarantee 
that an authorization to market or import the product or a laboratory certification will be received. A regulatory authority may impose 
requirements as a condition to granting an approval, clearance, premarket authorization or certification that may include significant 
restrictions or limitations. The regulatory authority may delay or refuse to grant premarket authorization, even though a product has 
been approved or registered without restrictions or limitations in another country or by another agency. Delays in receipt or failure to 
receive  such  approvals,  clearances,  premarket  authorization  or  certification  could  have  a  material  adverse  effect  on  our  business, 
financial condition and results of operations. 

We are developing and are or will be seeking EUA for a rapid pan-SARS coronavirus antigen self-test and a lab-based SARS-CoV-2 
oral fluid antibody test.  There is no assurance that we will obtain an EUA for either or both of these products.  Failure to do so could 
result in the loss of potential future revenues and adversely affect our business and results of operations.

36

All  in  vitro  diagnostic  products  that  are  to  be  sold  in  the  EU  must  bear  the  CE  mark  indicating  conformance  with  the  essential 
requirements of the IVDD. We have obtained the CE mark for several of our existing products. We also intend to apply for CE marks 
for certain of our future products and are not aware of any material reason why we would be unable to obtain those marks. However, 
there can be no assurance that compliance with all provisions of the IVDD will be demonstrated and the CE mark will be obtained or 
maintained  for  all  products  that  we  desire  to  sell  in  the  EU.  The  failure  to  obtain  or  maintain  the  CE  mark  for  one  or  more  of our 
products could lead to the termination of strategic alliances and agreements for sales of those products in the EU. 

In  addition,  we  or  our  distributors  are  often  required  to  obtain  premarket  authorization  or  product  registration  with  foreign 
governments or regulatory bodies before we can import and sell our products in foreign countries. We may also be required to obtain 
WHO  pre-qualification  or  endorsement  in  order  to  sell  certain  products  in  international  markets  or  enable  our  customers  to  access 
interested funding sources for our products. We may have difficulty obtaining such authorizations, registrations, pre-qualifications or 
endorsements and, if obtained, such authorizations, registrations, pre-qualifications or endorsements may contain restrictions that limit 
our  ability  to  market  and  sell  our  products  in  the  relevant  country.  In  addition,  any  change  in  our  arrangement  with  a  foreign 
distributor could result in the loss of or delay in transfer of any applicable product registrations, thereby interrupting our ability to sell 
those products in the affected markets. 

Failure  to  Comply  With  FDA  or  Other  Regulatory  Requirements  May  Require  Us  to  Suspend  Production  or  Sale  of  Our 
Products or Institute a Recall Which Could Result in Higher Costs and a Loss of Revenues. 

Regulation  by  the  FDA  and  other  federal,  state  and  foreign  regulatory  agencies  impacts  many  aspects  of  our  operations,  and  the 
operations  of  our  suppliers  and  distributors,  including  manufacturing,  labeling,  packaging,  adverse  event  reporting,  recalls, 
distribution, storage, advertising, promotion and record keeping. We are subject to routine inspection by the FDA and other agencies 
to determine compliance with QSR and FDA regulatory requirements in the United States and other applicable regulations worldwide, 
including  but  not  limited  to  ISO  standards.  We  believe  that  our  facilities  and  procedures  are  in  material  compliance  with  the  FDA 
requirements and ISO standards, but the regulations may be unclear and are subject to change, and we cannot be sure that the FDA or 
other regulators will agree with our compliance with these requirements. The FDA and foreign regulatory agencies may require post-
marketing testing and surveillance to monitor the performance of approved or cleared products or impose conditions on any product 
clearances  or  approvals  that  could  restrict  the  distribution  or  commercial  applications  of  those  products.  Regulatory  agencies  may 
impose  restrictions  on  our  or  our  distributors’  advertising  and  promotional  activities  or  preclude  these  activities  altogether  if  a 
noncompliance is believed to exist. In addition, the subsequent discovery of previously unknown problems with a product may result 
in restrictions on the product or additional regulatory actions, including withdrawal of the product from the market. 

Failure  to  comply  with  the  applicable  requirements  of  the  FDA  can  result  in,  among  other  things,  483  notices,  warning  letters, 
administrative  or  judicially  imposed  sanctions  such  as  injunctions,  civil  penalties,  recall  or  seizure  of  products,  total  or  partial 
suspension  of  production,  refusal  to  grant  premarket  clearance  or  PMA  approval  for  devices,  withdrawal  of  product  registrations, 
marketing clearances or approvals, or criminal prosecution. The ability of our suppliers to supply critical components or materials and 
of  our  distributors  to  sell  our  products  could  also  be  adversely  affected  if  their  operations  are  determined  to  be  out  of  compliance. 
Such actions by the FDA and other regulatory bodies could adversely affect our revenues, costs and results of operations. 

Some of our products, particularly those sold by DNAG, are sold for research purposes in the U.S. We do not promote these products 
for  clinical  diagnostic  use  and  they  are  labeled  “For  Research  Use  Only”,  or  RUO.  If  the  FDA  were  to  disagree  with  our  RUO 
designation of a product, we could be forced to stop selling the product until appropriate regulatory clearance or approval has been 
obtained. 

In the ordinary course of business, we must frequently make subjective judgments with respect to compliance with applicable laws 
and regulations. If regulators subsequently disagree with the manner in which we have sought to comply with these regulations, we 
could be subjected to substantial civil and criminal penalties, as well as product recall, seizure or injunction with respect to the sale of 
our products. The assessment of any civil and criminal penalties against us could severely impair our reputation within the industry 
and any limitation on our ability to manufacture and market our products could have a material adverse effect on our business. 

Our Inability to Respond to Changes in Regulatory Requirements Could Adversely Affect Our Business. 

We believe that our products and procedures are in material compliance with all applicable FDA regulations, ISO requirements, and 
other applicable regulatory requirements, but the regulations regarding the manufacture and sale of our products, the QSR and ISO 
requirements, and other requirements may be unclear and are subject to change. Newly promulgated regulations could require changes 
to our products, necessitate additional clinical trials or procedures, or make it impractical or impossible for us to market our products 
for certain uses, in certain markets, or at all. The FDA and other regulatory authorities also have the ability to change the requirements 
for obtaining product approval and/or impose new or additional requirements as part of the approval process. These changes or new or 
additional  requirements  may  occur  after  the  completion  of  substantial  clinical  work  and  other  costly  development  activities.  The 

37

implementation of such changes or new or additional requirements may result in additional clinical trials and substantial additional 
costs and could delay or make it more difficult or complicated to obtain approvals and sell our products. We cannot predict the effect, 
if any, that these changes might have on our business, financial condition or results of operations. 

Our  Inability  to  Manufacture  Products  in  Accordance  With  Applicable  Specifications,  Performance  Standards  or  Quality 
Requirements Could Adversely Affect Our Business. 

The materials and processes used to manufacture our products must meet detailed specifications, performance standards and quality 
requirements to ensure our products will perform in accordance with their label claims, our customers’ expectations and applicable 
regulatory requirements. As a result, our products and the materials used in their manufacture or assembly undergo regular inspections 
and  quality  testing.  Factors  such  as  defective  materials  or  processes,  mechanical  failures,  human  errors,  environmental  conditions, 
changes in materials or production methods, and other events or conditions could cause our products or the materials used to produce 
or assemble our products to fail inspections and quality testing or otherwise not perform in accordance with our label claims or the 
expectations of our customers. 

Any  failure  or  delay  in  our  ability  to  meet  the  applicable  specifications,  performance  standards,  quality  requirements  or  customer 
expectations could adversely affect our ability to manufacture and sell our products or comply with regulatory requirements. These 
events could, in turn, adversely affect our revenues and results of operations. 

We Are Subject to Numerous Government Regulations in Addition to FDA Requirements, Which Could Increase Our Costs 
and Affect Our Operations. 

In addition to the FDA and other regulations described previously, laws and regulations in some states may restrict our ability to sell 
products in those states. While we intend to work with state legislators and regulators to remove or modify any applicable restrictions, 
there is no guarantee we will be successful in these efforts. 

We must also comply with numerous laws relating to such matters as safe working conditions, manufacturing practices, environmental 
protection, fire hazard control, disposal of hazardous substances, labor or employment practices and the configuration and operation of 
the websites through which we advertise our products. As a device manufacturer, we are required to report annually to the Centers for 
Medicare & Medicaid Services (“CMS”) any payments or transfers of value we have made to physicians and teaching hospitals and 
any physician ownership or investment interest in the Company.  Compliance with these laws or any new or changed laws regulating 
our business could result in substantial costs. Because of the number and extent of the laws and regulations affecting our industry, and 
the number of governmental agencies whose actions could affect our operations, it is impossible to reliably predict the full nature and 
impact of these requirements. To the extent the costs and procedures associated with complying with these laws and requirements are 
substantial or it is determined that we do not comply, our business and results of operations could be adversely affected. 

Failure to Comply With Privacy, Security and Breach Notification Regulations May Increase Our Costs. 

In  the  past,  the  Health  Insurance  Portability  and  Accountability  Act  of  1996,  as  amended  (“HIPAA”)  has  generally  affected  us 
indirectly,  as  the  Company  is  generally  neither  a  Covered  Entity  nor  a  Business  Associate,  as  further  defined  under  HIPAA,  to 
Covered Entities.  We recently completed a merger of our wholly owned subsidiary, UrSure, Inc. Given that UrSure, Inc. collects 
certain  protected  health  information,  or  PHI,  it  is  a  Business  Associate  subject  to  HIPAA.    As  a  result  of  the  merger,  the  PHI 
collected  cannot  be  walled  off  from  the  Company  and  the  Company  is  now  subject  to  HIPAA.    We  have  in  place  certain 
administrative,  technical  and  physical  safeguards  to  protect  the  privacy  and  security  of  consumers’  personal  information  and 
endeavors to comply with all applicable state and federal laws with respect to the protection of consumers’ personal information. 
The  Company  is  required  to  comply  with  varying  state  privacy,  security  and  breach  reporting  laws.  If  we  do  not  comply  with 
existing or new laws and regulations related to properly transferring data containing consumers’ personal information, we could be 
subject to monetary fines, civil penalties or criminal sanctions. In addition to other federal and state laws that protect the privacy 
and security of consumers’ personal information, we may be subject to enforcement and interpretations by various governmental 
authorities and courts resulting in complex compliance issues. Moreover, the potential for enforcement action against us is now 
greater, as the U.S. Department of Health and Human Services (HHS) can take action directly against Business Associates. Thus, 
while we believe we are and will be in compliance with all required HIPAA standards, there is no guarantee that the government 
will  agree.  Enforcement  actions  can  be  costly  and  interrupt  regular  operations  of  our  business.  For  example,  we  could  incur 
damages  under  state  laws  pursuant  to  an  action  brought  by  a  private  party  for  the  wrongful  use  or  disclosure  of  consumers’ 
personal information. 

38

 
Failure to Comply With Data Protection Requirements or Privacy Laws Could Increase Our Costs.

The European Union (“EU”) has adopted a comprehensive overhaul of its data protection regime from the prior national legislative 
approach to a single European Economic Area Privacy Regulation called the General Data Protection Regulation (“GDPR”), which 
came into effect on May 25, 2018.  The new EU data protection regime extends the scope of the EU data protection law to all foreign 
companies  processing  data  of  EU  residents.  It  provides  for  a  harmonization  of  the  data  protection  regulations  throughout  the  EU, 
thereby making it easier for non-European companies to comply with these regulations.  It imposes a strict data protection compliance 
regime with severe penalties of up to the greater of 4% of worldwide turnover and €20 million and includes new rights such as the 
“portability” of personal data.  Although the GDPR will apply across the EU without a need for local implementing legislation, as had 
been the case under the prior data protection regime, local data protection authorities will still have the ability to interpret the GDPR, 
which  has  the  potential  to  create  inconsistencies  on  a  country-by-country  basis.  We  are  implementing  a  plan  to  ensure  compliance 
with these new requirements.  Complying with the enhanced obligations imposed by the GDPR may result in significant costs to our 
business  and  require  us  to  amend  certain  of  our  business  practices.  Further,  we  have  no  assurances  that  violations  will  not  occur, 
particularly given the complexity of the GDPR, as well as the uncertainties that accompany new, comprehensive legislation.

We are also subject to the California Consumer Privacy Act of 2018 (“CCPA”), which took effect on January 1, 2020.  The CCPA 
imposes extensive new requirements and protections on the processing of personal data, aimed at giving California consumers more 
visibility and control over their personal information.  Failure to comply with the CCPA or other data processing or security laws, or 
any changes in these laws, could adversely impact our business and our business plans.

Given  the  recent  integration  of  UrSure,  we  now  collect,  process  or  maintain  sensitive  information,  such  as  patient  data  and  other 
personal  information,  on  a  limited  basis.  If  we  do  use  or  not  adequately  safeguard  that  information  in  compliance  with  applicable 
requirements under state, federal and international laws, or if it were disclosed to persons or entities that should not have access to it, 
our business could be materially impaired, our reputation could suffer and we could be subject to fines, penalties and litigation. In the 
event of a data security breach, we may be subject to notification obligations, litigation and governmental investigation or sanctions, 
and  may  suffer  reputational  damage,  which  could  have  an  adverse  impact  on  our  business.  We  are  subject  to  laws  and  regulations 
regarding protecting the security and privacy of certain healthcare and personal information, including: (a) HIPPA and the regulations 
thereunder, which establish (i) a complex regulatory framework including requirements for safeguarding protected health information 
and (ii) comprehensive federal standards regarding the uses and disclosures of protected health information.

 FDA Regulation of Laboratory-Developed Tests and Genetic Testing Could Affect Demand For Our Products. 

The  FDA  has  regulatory  responsibility  over  instruments,  test  kits,  reagents  and  other  devices  used  to  perform  diagnostic  testing  by 
clinical  laboratories.  In  the  past,  the  FDA  has  taken  the  position  that  it  has  regulatory  authority  over  laboratory-developed  tests,  or 
LDTs,  but  has  exercised  enforcement  discretion  in  not  regulating  most  LDTs  performed  by  high  complexity  CLIA-certified 
laboratories. LDTs are tests designed, developed, and performed in-house by a laboratory. Such laboratories are subject to regulation 
under CLIA but have not been subject to regulation by the FDA under the agency’s medical device requirements. A significant portion 
of the total volume of genetic or molecular testing is performed with LDTs. 

In mid-2010, the FDA announced that it would begin regulating LDTs, including laboratory developed molecular tests, and in October 
2014 issued proposed guidance on the regulation of LDTs for public comment. On January 13, 2017, the FDA released a discussion 
paper synthesizing public comments on the 2014 draft guidance documents and outlining a possible approach to regulation of LDTs. 
The  discussion  paper  has  no  legal  status  and  does  not  represent  a  final  version  of  the  LDT  draft  guidance  documents.  We  cannot 
predict what policies will be adopted with respect to regulating LDTs. 

Our subsidiary, DNAG, sells its DNA collection systems to certain laboratories and other customers for use with LDTs. The FDA’s 
increased regulation of LDTs could make it more difficult for laboratories and other customers to continue offering LDTs that involve 
genetic or molecular testing. This, in turn, could increase costs, delay the introduction of new LDT’s and reduce demand for DNAG’s 
products and adversely impact our revenues. 

In  2019,  the  Department  of  Justice  (“DOJ”)  indicted  a  number  of  telemedicine  companies  and  cancer  genetic  testing  (“CGx”) 
laboratories  for  allegedly  submitting  fraudulent  insurance  claims  to  Medicare.    A  number  of  these  companies  were  customers  of 
DNAG.  As  a  result  of  these  activities,  the  FDA  has  issued  letters  to  genetic  testing  laboratories  indicating  that  it  plans  to  increase 
oversight  of  this  market  which  has  caused  some  of  these  companies  to  stop  providing  testing  options  or  to  change  how  they  are 
reporting  the  information  provided  by  the  testing.    The  activities  have  negatively  affected  this  market  and  there  is  a  risk  that  these 
enforcement  actions  will  continue  to  negatively  affect  this  market  by  forcing  laboratories  to  either  stop  offering  such  services  or 
restricting the use of such services.  Such a reduction in testing could result in decreased sales of our DNA collection devices.

39

 Our International Sales Create Potential Exposure Under Anti-Corruption Laws. 

We have a policy in place prohibiting our employees, distributors and agents from engaging in corrupt business practices, including 
activities  prohibited  by  the  United  States  Foreign  Corrupt  Practices  Act  (the  “FCPA”)  and  similar  foreign  laws.    In  2020, 
approximately  $40.9 million  of  our  consolidated  net  revenues  were  generated  from  sales  in  a  variety  of  foreign  countries.  These 
international  activities  subject  us  to  the  FCPA,  the  U.K.  Bribery  Act  and  other  laws  that  prohibit  improper  payments  or  offers  of 
payments to foreign governments and their officials and political parties by business entities for the purpose of obtaining or retaining 
business. We have operations, enter into agreements with third parties and make sales in countries known to experience corruption. 
Further  international  expansion,  including  the  acquisition  of  foreign  entities,  may  create  increased  exposure  to  such  practices.  Our 
activities in these countries create the risk of unauthorized payments or offers of payments by one of our employees, consultants, sales 
agents or distributors that could be in violation of various laws, including the FCPA, even though these parties are not always subject 
to  our  control.  It  is  our  policy  to  implement  safeguards  to  discourage  these  practices  by  our  employees  and  distributors,  including 
employee  training,  contracts  requiring  compliance  with  the  FCPA  and  similar  rules,  and  standard  reviews  of  our  distributors. 
However, our existing safeguards and any future improvements may not prove to be effective, and our employees, consultants, sales 
agents or distributors may engage in conduct for which we might be held responsible. Violations of the FCPA and other laws may 
result in criminal or civil sanctions, which could be severe and we may be subject to other liabilities, which could negatively affect our 
reputation, business, results of operations and financial condition. 

Risks Relating to the Economy, Our Financial Results, Investments, Credit Facilities and Need for Financing

Economic  Volatility  and  Disruption,  Including  Those  Related  To  The  COVID-19  Pandemic,  Could  Adversely  Affect  Our 
Business, Financial Performance, Results of Operations, Cash Flow and Financial Condition or Those of Our Customers and 
Suppliers.

Global and U.S. markets and economies have experienced extreme volatility and disruption following the global outbreak of COVID-
19 that began in December 2019. Many economists and major investment banks have expressed concern that the continued spread of 
the virus globally has led or will lead to a world-wide economic downturn. Volatile economic conditions may occur again or continue 
in the future.

Although  the  severity  and  duration  of  the  COVID-19  pandemic  cannot  be  reasonably  estimated  at  this  time,  impacts  that  we  may 
experience include, but are not limited to:

•
•
•
•

•

•

•

•
•
•

a slowdown or stoppage in the supply chain of the raw materials and components used to manufacture our products;
interruptions or delays in international shipment of our products to our distributors and customers;
interruptions in normal operations of certain end-use customers that could result in reductions in demand for our products;
disruptions to our operations, including a shutdown of our facilities or product lines; restrictions on our operations and sales, 
marketing and distribution efforts; and interruptions to our research and development, manufacturing, clinical/regulatory and 
other important business activities;
shutdown  or  interruption  of  our  manufacturing  facilities  due  to  contamination  and  costs  incurred  to  clean  and  disinfect  a 
facility following contamination;
inefficiencies  and  increased  costs  in  our  production  and  shipping  processes  due  to  premium  pay  for  manufacturing  and 
certain other employees as well as social distancing and personal protective equipment requirements;
limitations  on  employee  resources  and  availability,  including  due  to  sickness,  government  restrictions,  the  desire  of 
employees to avoid contact with large groups of people or mass transit disruptions;
a fluctuation in foreign currency exchange rates or interest rates could result from market uncertainties;
an increase in exposure to credit losses for customers adversely affected by the COVID-19 pandemic; and
an  increase  in  regulatory  restrictions  or  continued  market  volatility  could  hinder  our  ability  to  execute  strategic  business 
activities, including acquisitions.

These  conditions  could  adversely  affect  our  financial  performance  and  condition  or  those  of  our  customers  and  suppliers.  These 
circumstances  could  also  adversely  affect  our  access  to  liquidity  needed  to  conduct  or  expand  our  business  or  conduct  future 
acquisitions  or  make  other  discretionary  investments.  Many  of  our  customers  rely  on  public  funding  provided  by  federal,  state  and 
local governments, and this funding has been and may continue to be reduced or deferred as a result of economic conditions or other 
factors. These circumstances may adversely impact our customers and suppliers, which, in turn, could adversely affect their ability to 
purchase  and/or  distribute  our  products  or  supply  us  with  necessary  equipment,  raw  materials  or  components.  Any  or  all  of  these 
effects would have an adverse effect on our operations, business, financial condition and results of operations.

40

 
The duration of the COVID-19 pandemic is unknown, and it is difficult to predict the full extent of potential impacts the pandemic 
will have in the future on our business, operations, and financial results, or on our customers, suppliers or logistics providers, or on the 
global economy as a whole. It is uncertain how materially the COVID-19 pandemic will affect our global operations, particularly if 
the effects continue or get worse over an extended period of time. Even with the improvement of economic conditions, it may take 
time  for  our  customers  and  suppliers  to  establish  new  budgets  and  return  to  normal  purchasing  and  shipping  patterns.  We  cannot 
predict the reoccurrence of any economic slowdown or the strength or sustainability of an economic recovery.

An Impairment of Goodwill and Intangible Assets Could Reduce our Earnings.

At  December  31,  2020,  our  consolidated  balance  sheet  reflected  approximately  $40.4  million  of  goodwill  and  approximately  $17.9 
million of intangible assets.  Goodwill is recorded when the purchase price of a business exceeds the fair value of the tangible and 
separately measurable intangible net assets. U.S. generally accepted accounting principles (“U.S. GAAP”) require us to test goodwill 
for  impairment  on  an  annual  basis  or  when  events  or  circumstances  occur  indicating  that  goodwill  might  be  impaired.    Long-lived 
assets,  such  as  intangible  assets  with  finite  useful  lives,  are  reviewed  for  impairment  whenever  events  or  changes  in  circumstances 
indicate that the carrying amount may not be recoverable.  The impairment review often cannot be done at the level of the individual 
asset  and  it  must  instead  be  applied  to  a  group  of  assets.    For  the  purpose  of  our  annual  goodwill  impairment  testing  based  on the 
current circumstances of how we manage or business, this group of assets is the Company as a whole.  If we determine that any of our 
goodwill or intangible assets were impaired, we will be required to take an immediate charge to earnings and our results of operations 
could be adversely affected.

We Have Experienced Losses in the Past and May Not Be Able To Maintain Profitable Operations.

We experienced annual net losses during the five years prior to 2015 and again in 2020.  In addition, as of December 31, 2020, the 
Company had an accumulated deficit of $96.9 million.  Even though we achieved profitability in 2015 through 2019, there can be no 
assurance that we will be able to sustain his profitability in the future.

Our ability to continue profitable operations in the future will be dependent upon a number of factors including, without limitation, the 
following:

• Our ability to continue growing sales of our molecular collection products and related genomic and microbiome laboratory 

services;

• Our ability to successfully commercialize a rapid pan-SARS coronavirus antigen self-test and a lab-based SARS-CoV-2 oral 

fluid antibody test;

• Our ability to mitigate declining sales of our OraQuick ADVANCE® HIV 1/2 test in the United States and expand sales of our 

OraQuick® HIV Self-Test internationally;

•

•

Changes  in  customer  buying  patterns  or  a  buildup  of  significant  quantities  in  our  distributors’  inventories  or  distribution 
channels; and

The  level  of  expenditures  we  are  required  to  make  in  order  to  develop,  obtain  regulatory  approvals  for  and  successfully 
commercialize our new products;

• Our  ability  to  expand  our  business  through  the  acquisition  of  other  companies  or  technologies  or  through  internal 

development of new or improved products;
• Our ability to improve manufacturing efficiencies;
• Our ability to successfully launch new products after receipt of required regulatory approvals or the acquisition of rights to 

those products;

•

The  degree  to  which  our  major  distributors  and  customers  comply  with  their  contractual  obligations,  including  minimum 
purchase commitments;

• Whether we are successful in obtaining and maintaining required regulatory approvals and registrations for our new products;
•
The level of competition, including the degree to which competitors sell lower priced products or more attractive offerings to 
compete with our products;

•

Changes  in  economic  conditions  in  domestic  or  international  markets,  such  as  economic  downturns,  reduced  demand, 
inflation and currency fluctuations;

41

•

•

Failure to achieve our revenue growth targets;

The costs and results of patent infringement, product liability and other litigation or claims asserted by or against us.

Changes in Foreign Currency Exchange Rates Could Negatively Affect Our Operating Results. 

Our financial statements are stated in U.S. Dollars and, historically, most of our international sales have also been denominated in U.S. 
Dollars. As a result, in the past our exposure to foreign currency exchange rate risk has not been material. Nonetheless, these sales are 
subject  to  currency  risks,  since  changes  in  the  values  of  foreign  currencies  relative  to  the  value  of  the  U.S.  dollar  can  render  our 
products comparatively more expensive. These exchange rate fluctuations could negatively impact international sales of our products, 
as could changes in the general economic conditions in those markets. 

In addition, the revenues and expenses of our subsidiary, DNAG, are recorded in Canadian Dollars and the revenues and expenses of 
our subsidiary Novosanis are recorded in Euros. Revenues and expenses denominated in foreign currencies are translated into U.S. 
dollars for purposes of reporting our consolidated financial results. Our expectation is that the businesses of our foreign subsidiaries 
will continue to grow and our exposure to foreign currency exchange rates may be more significant than in past years. 

Exchange  rate  fluctuations  may  affect  the  revenues  and  expenses  of  our  foreign  subsidiaries  and  the  translation  of  those  financial 
results  into  U.S.  dollars.  Favorable  movement  in  exchange  rates  have  benefited  us  in  prior  periods.  However,  where  there  are 
unfavorable  currency  exchange  rate  fluctuations,  our  consolidated  financial  statements  including  our  balance  sheet,  revenues  and 
results of operations, could be negatively affected. In addition, fluctuations in exchange rates could affect year-to-year comparability 
of operating results. In the past, we have not generally entered into hedging instruments to manage our currency exchange rate risk, 
but we may need to do so in the future. However, our attempts to hedge against these risks may not be successful. If we are unable to 
successfully  hedge  against  unfavorable  foreign  currency  exchange  rate  movements,  our  consolidated  financial  results  may  be 
adversely impacted. 

Risks Relating to Our Common Stock

Our Stock Price Could Continue to be Volatile. 

Our stock price has been volatile, has fluctuated substantially in the past, may be volatile in the future and could experience substantial 
declines. The following factors, among others, could have a significant impact on the market for our Common Stock: 

•

The  performance  of  our  business,  including  our  efforts  to  increase  sales  of  our  OraQuick®  HIV,  HCV  and  Molecular 
Solutions products and our OraQuick® In-Home HIV test and HIV Self-Test; 

• Our efforts to expand sales of our genomic and microbiome laboratory service offerings;
• Our efforts to commercialize a rapid pan-SARS coronavirus antigen test and a lab-based SARS-CoV-2 oral fluid antibody 

test;

•

Future announcements concerning us and our products or services, including with respect to significant acquisitions, strategic 
collaborations and joint ventures; 

• Ability to achieve the expected benefits, enhanced revenue growth and synergies from strategic acquisitions;
•

Clinical results with respect to our products or services or those of our competitors; 

•

•

•

The status of clinical studies and pending submissions for required regulatory approvals; 

The announcement of regulatory or enforcement actions by the FDA or other agencies against us, our products or services, or 
one or more of our customers; 

The gain or loss of significant contracts and availability of funding for the purchase of our products and services; 

• Delays in the development, regulatory approval or commercialization of new or enhanced products or services; 
•

Legislative developments and industry or competitive trends; 

•

Biological or medical discoveries; 

• Disputes or developments with key customers, distributors or suppliers; 
• Developments in patent or other proprietary rights; 
•

Litigation or threatened litigation; 

42

 
•

•

Complaints or concerns about the performance or safety of our products and publicity about those issues, including publicity 
expressed through social media or otherwise over the internet; 

Failure to achieve, or changes in, financial estimates by securities analysts and comments or opinions about us by securities 
analysts or major stockholders; 

• Governmental regulation; 
•

Changes in the level of competition; 

•

•

Loss of or declines in sales to major distributors or customers or changes in the mix of products sold; 

Period-to-period fluctuations in our operating results; 

• Additions or departures of key personnel; 
• General market and economic conditions; and 
•

Terrorist attacks, civil unrest, war and national disasters, including pandemics. 

In addition, the stock market in general has experienced extreme price and volume fluctuations that have affected the market price of 
our Common Stock, as well as the stock of many companies in the diagnostics and life sciences industries. Often, price fluctuations 
are unrelated to the operating performance of the specific companies whose stock is affected. 

In  the  past,  following  periods  of  volatility  in  the  market  price  of  a  company’s  stock,  securities  class  action  litigation  has  occurred 
against the issuing company. If we were subject to this type of litigation in the future, we could incur substantial costs and experience 
a  subsequent  diversion  of  our  management’s  attention  and  resources,  each  of  which  could  have  a  material  adverse  effect  on  our 
revenue and earnings. Any adverse determination in this type of litigation could also subject us to significant liabilities. 

Future Sales of Our Common Stock by Existing Stockholders, Executive Officers or Directors Could Depress the Market Price 
of Our Common Stock and Make It More Difficult For Us to Sell Stock in the Future. 

Sales of our Common Stock in the public market, or the perception that such sales may occur, could negatively impact the market 
price of our Common Stock. We are unable to estimate the number of shares of our Common Stock that may actually be resold in the 
public market since this will depend on the market price for our Common Stock, the individual circumstances of the sellers and other 
factors. 

We  have  a  number  of  institutional  stockholders  that  own  significant  blocks  of  our  Common  Stock.  If  one  or  more  of  these 
stockholders sell large portions of their holdings in a relatively short time, for liquidity or other reasons, the prevailing market price of 
our Common Stock could be negatively affected. In addition, it is possible that one or more of our executive officers or non-employee 
members of our Board of Directors could sell shares of our Common Stock during an open trading window or pursuant to a 10b5-1 
sales plan under our Insider Trading Policy. These transactions and the perceived reasons for these transactions could have a negative 
effect on the prevailing market price of our Common Stock. 

Because We Do Not Intend to Pay Cash Dividends on Our Common Stock, an Investor in Our Common Stock Will Benefit 
Only if Our Stock Appreciates in Value. 

We  currently  intend  to  retain  our  current  earnings  and  future  earnings,  if  any,  to  finance  the  expansion  of  our  business  and  do  not 
expect to pay any cash dividends on our Common Stock in the foreseeable future. As a result, the success of an investment in our 
Common Stock will depend entirely upon any future appreciation. There is no guarantee that our Common Stock will appreciate in 
value or even maintain the price at which investors purchased their shares. 

Certain  Provisions  in  Our  Certificate  of  Incorporation  and  Bylaws  and  Under  Delaware  Law  Could  Make  a  Third-Party 
Acquisition of Us Difficult. 

Our Certificate of Incorporation and Bylaws contain provisions that could make it more difficult for a third party to acquire us, even if 
doing so would be beneficial to our stockholders. We are also subject to certain provisions of Delaware law that could delay, deter or 
prevent a change in control of us. These provisions could limit the price investors might be willing to pay in the future for shares of 
our Common Stock. 

43

General Risk Factors

We May Face Product Liability Claims for Injuries Resulting From the Use of Our Products. 

We may be held liable if any of our products, or any product which is made with the use or incorporation of any of our technologies, 
causes injury of any type or is found otherwise unsuitable during product testing, manufacturing, marketing, sale or usage. There is no 
assurance that we would be successful in defending any product liability lawsuits brought against us. Moreover, there is no assurance 
that our products will not be included in unethical, illegal or inappropriate research or applications, which may in turn put us at risk of 
litigation.  Regardless of merit or eventual outcome, product liability claims could result in: 

• Decreased demand for our products; 
•

Lost revenues; 

• Damage to our image or reputation; 
•

Costs related to litigation; 

•

Increased product liability insurance costs; 
• Diversion of management time and attention; and 
•

Incurrence of damages payable to plaintiffs. 

We  are  selling  the  OraQuick®  In-Home  HIV  test  in  the  United  States  OTC  market,  and  we  offer  HIV  Self-Tests  to  consumers 
internationally. We believe the sale of products for use by consumers increases our potential exposure to product liability and other 
claims. 

Performance of Our Products May Affect Our Revenues, Stock Price and Reputation. 

Our products are generally sold with labeling that contains performance claims approved or cleared by the FDA or other regulators. 
However, our products may not perform as expected. For example, a defect in one of our diagnostic or specimen collection products 
or a failure by a customer to follow proper testing procedures, may cause the product to report inaccurate information such as a false 
positive  result  or  a  false  negative  result.  A  false  positive  or  negative  result  can  also  occur  even  when  there  is  no  apparent  product 
defect and the customer has apparently used our product properly. Identifying the root cause of a product performance or quality issue 
can be difficult and time consuming. 

If  our  products  fail  to  perform  in  accordance  with  the  applicable  label  claims  or  otherwise  in  accordance  with  the  expectations  or 
needs of our customers, customers may switch to a competing product or otherwise stop using our products, and our revenues could be 
adversely affected. Under such circumstances, we may be required to implement shipment holds or product recalls and incur warranty 
obligations, which would increase our costs. In addition, poor performance by one or more of our products and publicity surrounding 
such  performance  could  have  an  adverse  effect  on  our  reputation,  our  continuing  ability  to  sell  products  and  the  prevailing  market 
price of our Common Stock. 

Our Ability to Sell Products Could be Adversely Affected by Competition From New and Existing Products and Services. 

The markets we serve are highly competitive and rapidly changing and we expect competition to intensify as technological advances 
are  made  and  become  more  widely  known,  and  as  new  products  and  services  reach  the  market.  Many  of  our  principal  competitors 
have considerably greater financial, technical and marketing resources than we do. As new products and services enter the market, our 
products  and  services  may  become  obsolete  or  a  competitor’s  products  and  services  may  be  more  effective  or  attractive  or  more 
effectively  marketed  and  sold  than  ours.  In  addition,  there  can  be  no  assurance  that  our  competitors  will  not  succeed  in  obtaining 
regulatory  approval  for  new  products  and  services  that  would  render  our  technologies,  products  and  services  obsolete  or  otherwise 
commercially unattractive, or introduce or commercialize such products and services before we can do so. If we fail to convince our 
customers  of  the  advantages  and  economic  value  of  our  products  and  services  or  otherwise  maintain  and  enhance  our  competitive 
position, our customers may decide to use products and services developed by competitors which could result in a loss of revenues. 
These developments could have a material adverse effect on our business, financial condition and results of operations. 

We also face competition from products that are sold at a lower price. Where this occurs, customers may choose to buy lower cost 
products from third parties or we may be forced to sell our products at a lower price, both of which could result in a loss of revenues 
or a lower gross margin contribution from the sale of our products. We may also be required to increase our marketing efforts in order 
to compete effectively, which would increase our costs. 

44

Failure to Achieve Our Financial and Strategic Objectives Could Have a Material Adverse Impact on Our Business Prospects. 

As a result of any number of risk factors identified in this Annual Report, no assurance can be given that we will be successful in 
implementing our financial and strategic objectives, including our efforts to increase sales of our products and services or continue 
growing our business. In addition, the funds for research, clinical development and other projects have in the past come primarily from 
our  business  operations.  If  our  business  slows  and  we  have  less  money  available  to  fund  research  and  development  and  clinical 
programs, we will have to decide at that time which programs to cut, and by how much. Similarly, if adequate financial, personnel, 
equipment  or  other  resources  are  not  available,  we  may  be  required  to  delay  or  scale  back  our  business.  Our  operations  will  be 
adversely affected if our total revenue and gross profits do not correspondingly increase or if our technology, product, service, clinical 
and  market  development  efforts  are  unsuccessful  or  delayed.  Furthermore,  our  failure  to  successfully  introduce  new  or  enhanced 
products and services and develop new markets could have a material adverse effect on our business and prospects. 

If We Lose Our Key Personnel or Are Unable to Attract and Retain Qualified Personnel as Necessary, Our Business Could be 
Harmed. 

Our success depends to a large extent upon the contributions of our executive officers, management and sales, marketing, operations 
and scientific staff. Our business may be harmed by the loss of a significant number of our executive officers or senior managers. We 
may not be able to attract or retain a sufficient number of qualified employees in the future due to the intense competition for qualified 
personnel among medical products, laboratory services and other life science businesses. Our ability to recruit such employees will 
depend on a number of factors, including compensation, benefits, work location, the prospects of our Company, and the possibility for 
advancement within our organization. We generally do not enter into employment agreements requiring our employees to work for us 
for any specified period. 

If we are not able to attract and retain the necessary personnel to accomplish our business objectives, we may experience constraints 
that  will  adversely  affect  our  ability  to  effectively  market  and  sell  our  products  and  services,  to  meet  the  demands  of  our  strategic 
partners in a timely fashion, or to support research, development and clinical programs. Although we believe we will be successful in 
attracting  and  retaining  qualified  personnel,  competition  for  experienced  scientists  and  other  qualified  personnel  from  numerous 
companies and academic and other research institutions may limit our ability to do so on acceptable terms. 

If Our Essential Employees Who Are Unable To Telework Become Ill or Otherwise Incapacitated, Our Operations May Be 
Adversely Impacted.

As  a  medical  device  manufacturer,  we  fall  within  a  “critical  essential  infrastructure”  sector,  specifically  the  “Healthcare/Public 
Health”  sector,  and  are  considered  exempt  under  various  stay  at  home/shelter  in  place  orders.  Accordingly,  our  employees  may 
continue to work because of the importance of our operations to the health and well-being of citizens in the states in which we operate. 
Consistent with these Stay at Home Orders, we have implemented telework policies wherever possible for appropriate categories of 
“nonessential”  employees.  “Essential”  employees  that  are  unable  to  telework  continue  to  work  at  our  facilities,  and  we  have 
implemented  appropriate  safety  measures,  including  social  distancing,  face  covering  and  increased  sanitation  standards.  We  are 
following guidance from the Center for Disease Control and the Occupational Safety and Health Administration regarding suspension 
of  nonessential  travel,  self-isolation  recommendations  for  employees  returning  from  certain  geographic  areas,  confirmed  reports  of 
any COVID-19 diagnosis among our employees, and the return of such employees to our workplace. Pursuant to updated guidance 
from the Equal Employment Opportunity Commission, we are engaging in limited and appropriate inquiries of employees regarding 
potential COVID-19 exposure, based on the direct threat that such exposure may present to our workforce. We continue to address 
other unique situations that arise among our workforce due to the COVID-19 pandemic on a case-by-case basis. While we believe that 
we have taken appropriate measures to ensure the health and wellbeing of our “essential” employees, there can be no assurances that 
our  measures  will  be  sufficient  to  protect  our  employees  in  our  workplace  or  that  they  may  otherwise  be  exposed  to  COVID-19 
outside  of  our  workplace.  If  a  number  of  our  essential  employees  become  ill,  incapacitated  or  are  otherwise  unable  to  continue 
working during the current or any future epidemic, our operations may be adversely impacted.

Increases  in  Demand  for  Our  Products  and  Services  Could  Require  Us  to  Expend  Considerable  Resources  or  Harm  Our 
Customer Relationships if We Are Unable to Meet That Demand. 

If we experience significant or unexpected increases in the demand for our products and services, we and our suppliers may not be 
able  to  meet  that  demand  without  expending  additional  capital  resources.  These  capital  resources  could  involve  the  cost  of  new 
products, machinery or new manufacturing or laboratory facilities. This would increase our capital costs, which could adversely affect 
our earnings. Our suppliers may be unable or unwilling to expend the necessary capital resources or otherwise expand their capacity. 
In  addition,  new  manufacturing  or  laboratory  equipment  and  facilities  may  require  FDA  approval  or  government  or  industry 
certification before they can be used to manufacture our products or provide laboratory services. To the extent we are unable to obtain 
or are delayed in obtaining such approvals, our ability to meet the demand for our products and services could be adversely affected. 

45

If  we  are  unable  to  develop  necessary  manufacturing  or  laboratory  capabilities  in  a  timely  manner,  our  sales  could  be  adversely 
affected.  If  we  fail  to  increase  these  capabilities  in  a  cost  effective  manner  or  if  we  experience  lower  than  anticipated  yields  or 
production  or  performance  problems  as  a  result  of  changes  that  we  make  in  our  manufacturing  or  laboratory  processes  to  meet 
increased demand, we could experience delays or interruptions and increased costs, which could also have a material adverse effect on 
our revenues and profitability. 

Unexpected increases in demand for our products may require us to obtain additional raw materials in order to manufacture products 
to meet the demand. Some raw materials require significant ordering lead time and some are currently obtained from a sole supplier or 
a limited group of suppliers. We have long-term supply agreements with certain of these suppliers, but these long-term agreements 
involve risks for us, such as our potential inability to obtain an adequate supply of raw materials and components and our reduced 
control  over  pricing,  quality  and  timely  delivery.  It  is  also  possible  that  one  or  more  of  these  suppliers  may  become  unwilling  or 
unable to deliver materials to us. Any shortfall in our supply of raw materials and components, or our inability to quickly and cost-
effectively obtain alternative sources for this supply, could have a material adverse effect on our ability to meet increased demand for 
our products. This could negatively affect our total revenues or cost of sales and related profits. 

Our  inability  to  meet  customer  demand  for  our  products  and  services  could  also  harm  our  customer  relationships  and  impair  our 
reputation within the industry. This, in turn, could have a material adverse effect on our business and prospects. 

We  Rely  on  Information  Technology  in  Our  Operations  and  Any  Material  Failure,  Inadequacy,  Interruption  or  Security 
Breach of that Technology Could Harm Our Ability to Efficiently Operate Our Business. 

We rely heavily on enterprise resource planning and other complex information technology systems across our operations and on the 
internet, including for management of inventory, processing and analyzing laboratory specimens, purchase orders, invoices, shipping, 
revenue and expense accounting, online business, consumer call support, and various other processes and transactions. Our ability to 
effectively manage our business, coordinate the production, distribution and sale of our products, process and analyze specimens in 
our laboratories, respond to customer inquiries, and ensure the timely and accurate recording and disclosure of financial information 
depends significantly on the reliability and capacity of these systems and the internet. 

The failure of any of the foregoing systems to operate effectively, problems with transitioning to upgraded or replacement systems, or 
disruptions  in  the  operation  of  the  internet,  could  cause  delays  in  product  sales  or  the  provision  of  laboratory  services  and  reduced 
efficiency of our operations. Significant expenditures could be required to remediate any such problem. 

Security  Breaches  and  Other  Disruptions  Could  Compromise  Our  Information,  Expose  Us  To  Liability  and  Harm  Our 
Reputation and Business. 

In the ordinary course of our business, we collect and store sensitive data, including intellectual property, personal information, our 
proprietary business information and that of our customers, suppliers and business partners, and personally identifiable information of 
our  employees  in  our  data  centers  and  on  our  networks.  Secure  maintenance  and  transmission  of  this  information  is  critical  to  our 
operations  business  strategy.  We  generally  rely  on  commercially  available  systems,  software,  tools  and  domestically  available 
monitoring to provide security for processing, transmitting and storing this sensitive date. 

Cyber-attacks  could  result  in  unauthorized  access  to  our  computer  systems  or  our  third  party  IT  service  provider’s  systems  and,  if 
successful, misappropriate personal or confidential information. Spear phishing has occurred and is a growing threat that the Company 
is  facing.    If  successful,  these  activities  could  lead  to  the  disclosure  of  intellectual  property  or  personally  identifiable  information, 
which could lead to financial harm and cause reputational damage.  We have taken additional steps designed to improve the security 
of our networks and computer systems.  

In addition, a contractor or other third party with whom we do business may attempt to circumvent our security measures or obtain 
such information, and may purposefully or inadvertently cause a breach involving sensitive information. While we will continue to 
evaluate and implement additional protective measures to reduce the risk and detect cyber incidents, cyberattacks are becoming more 
sophisticated  and  frequent  and  the  techniques  used  in  such  attacks  change  rapidly.  Despite  our  cybersecurity  measures  (including 
employee and third party training, monitoring of networks and systems and maintenance of back up of protective systems) which are 
continuously  reviewed  and  upgraded,  our  information  technology  networks  and  infrastructure  may  still  be  vulnerable  to  damage, 
disruptions or shut downs due to attack by hackers or breaches, voyeur or malfeasance. 

46

Even  the  most  well  protected  IT  networks,  systems  and  facilities  remain  potentially  vulnerable  because  the  techniques  used  in 
attempted security breaches are continually evolving and generally are not recognized until launched against a target or, in some cases, 
are  designed  not  to  be  detected  and,  in  fact,  may  not  be  detected.  Any  such  compromise  of  our  or  our  third  party’s  IT  service 
providers’ data security and access, public disclosure, or loss of personal or confidential business information, could result in legal 
claims and proceedings, liability under laws to protect privacy of personal information, and regulatory penalties, and could disrupt our 
operations, require significant management attention and resources to remedy any damages that result, and damage our reputation and 
customers willingness to transact business with us, any of which could adversely affect our business. 

As  our  activities  continue  to  evolve  and  expand,  we  may  be  subject  to  additional  laws  which  impose  further  restrictions  on  the 
transfer,  access,  use,  and  disclosure  of  health  and  other  personal  information  which  may  impact  our  business  either  directly  or 
indirectly.    Our  failure  to  comply  with  applicable  privacy  or  security  laws  or  significant  changes  in  these  laws  could  significantly 
impact our business and future business plans.

Federal and State Laws Pertaining to Healthcare Fraud and Abuse Could Adversely Affect Our Business, Financial Condition 
and Results of Operations. 

We are subject to various federal and state laws targeting fraud and abuse in the healthcare industry, including anti-kickback laws, 
false  claims  laws,  laws  constraining  the  sales,  marketing  and  promotion  of  medical  devices  by  limiting  the  kinds  of  financial 
arrangements  that  manufacturers  of  these  products  may  enter  into  with  physicians,  hospitals,  laboratories  and  other  potential 
purchasers  of  medical  devices,  and  laws  requiring  the  reporting  of  certain  transactions  between  manufacturers  and  healthcare 
professionals.  Violations  of  these  laws  are  punishable  by  criminal  or  civil  sanctions,  including  substantial  fines,  imprisonment  and 
exclusion from participation in government healthcare programs such as Medicare and Medicaid. Many of the existing requirements 
have not been definitively interpreted by state authorities or courts, and available guidance is limited. Unless and until we are in full 
compliance with these laws, we could face enforcement action and fines and other penalties, and could receive adverse publicity, all of 
which  could  materially  harm  our  business.  In  addition,  changes  in  or  evolving  interpretations  of  these  laws,  regulations,  or 
administrative  or  judicial  interpretations,  may  require  us  to  change  our  business  practices  or  subject  our  business  practices  to  legal 
challenges, which could have a material adverse effect on our business, financial condition and results of operations. 

We May Experience Fluctuations in Our Financial Results or Fail to Meet Our Financial Projections. 

Our operating results can fluctuate from quarter to quarter and year to year, which could cause our growth or financial performance to 
fall below the expectations of investors and securities analysts. Our financial projections for future periods are based on a number of 
assumptions, including estimated demand for our products. However, sales to our distributors and other customers may fall short of 
expectations  because  of  lower  than  estimated  demand  or  other  factors,  including  continued  volatility  and  disruption  in  economic 
conditions,  increasing  competition,  seasonal  fluctuations,  changes  in  ordering  patterns  or  business  strategy,  reduced  governmental 
funding and other circumstances described elsewhere in this Annual Report. Infrequent, unusual or unexpected changes in revenues or 
costs could also contribute to the variability of our financial results. 

Customers  in  certain  of  the  markets  we  serve  often  submit  a  high  percentage  of  purchase  orders  in  the  third  month  of  a  calendar 
quarter. Although this can vary from quarter to quarter, many customers make purchase decisions late in a quarter due to budgetary or 
financial requirements. In addition, certain governmental customers must fully spend budgeted funds by the end of their fiscal year or 
risk  losing  these  funds,  which  can  contribute  to  fluctuations  in  our  sales  from  year-to-year.  This  can  make  it  difficult  to  accurately 
forecast whether we will achieve our quarterly sales forecasts and can cause variability in our operating results. 

In addition, our products provide different contributions to our gross margin. Accordingly, our operating results could also fluctuate 
and be affected by the mix of products sold and the relative prices and gross margin contribution of those products. Failure to achieve 
operating  results  consistent  with  the  expectations  of  investors  and  securities  analysts  could  adversely  affect  our  reputation  and  the 
price of our Common Stock. 

We May Require Future Additional Capital. 

Our future liquidity and ability to meet our future capital requirements will depend on numerous factors, including, but not limited to, 
the following: 

•

•

•

•

The costs, scope and timing of strategic acquisitions; 

The costs and timing of expansion of sales and marketing activities; 

The timing and success of the commercial launch of new products or services; 

The extent to which we gain or expand market acceptance for existing, new or enhanced products and services; 

47

•

•

•

•

•

•

•

•

The costs and timing of the expansion of our manufacturing and laboratory capacity; 

The success of our research and product development efforts; 

The time, cost and degree of success of conducting clinical trials and obtaining regulatory approvals; 

The magnitude of capital expenditures; 

Changes in existing and potential relationships with distributors and other business partners; 

The costs involved in obtaining and enforcing patents, proprietary rights and necessary licenses; 

The costs and liability associated with patent infringement or other types of litigation; and 

Competing technological and market developments. 

If additional financing is needed, we may seek to raise funds through the sale of equity or other securities or through bank borrowings. 
There  can  be  no  assurance  that  financing  through  the  sale  of  securities,  bank  borrowings  or  otherwise  will  be  available  to  us  on 
satisfactory terms, or at all. 

Terrorist  Attacks,  Natural  Disasters, Public  Health  Crises  or  Other  Catastrophic  Events  Outside  of  Our  Control  May 
Adversely Affect Our Business.

Terrorist attacks, natural disasters, public health crises or other catastrophic events outside of our control, including pandemics, and 
subsequent governmental responses to these events, could cause economic instability. These actions could adversely affect economic 
conditions both within and outside the United States and reduce demand for our products. For example, the COVID-19 outbreak has 
led  to,  and  for  an  unknown  period  of  time  will  continue  to  lead  to,  disruptions  in  local,  regional,  national  and  global  markets  and 
economies affected thereby, including the United States. This outbreak has resulted in, and until fully resolved is likely to continue to 
result in, among other things: (i) restrictions on travel, government mandated social distancing measures, and the temporary closure of 
many  corporate  offices,  retail  stores,  and  manufacturing  facilities  and  factories;  (ii) significant  disruption  to  the  business  of  many 
companies, including our customers and suppliers, as well as layoffs of employees; (iii) reduction or termination by public health and 
other  customers  of  infectious  disease  testing  programs,  including  for  HIV  and  HCV,  and  a  reallocation  of  personnel  and  monetary 
resources  from  these  programs  to  programs  intended  to  address  COVID-19;  (iv)  reduction  or  termination  of  clinical  and  research 
studies  by  academic  and  other  entities  that  use  our  molecular  collection  products  and  laboratory  services;  and  (v) rapidly  evolving 
proposals  and  actions  by  state  and  federal  governments  to  address  the  problems  being  experienced  by  markets,  businesses  and  the 
economy  in  general,  which  may  have  unintended  consequences  or  may  not  adequately  address  such  problems. These  events  have 
disrupted,  and  threaten  to  continue  to  disrupt,  our  normal  operation,  the  operations  of  our  customers  and  suppliers  and  eliminate, 
reduce  or  delay  our  customers’  ability  to  purchase  and  use  our  products  and  our  suppliers’  ability  to  provide  raw  materials  and 
finished products. Despite our efforts to manage and mitigate the impact of these events on us, it is impossible to predict the precise 
nature and consequences of these events, or of any political or policy decisions and regulatory changes occasioned by emerging events 
or uncertainty under applicable laws or regulations that impact us. It is clear that these types of events are impacting and will, for at 
least some time, continue to impact our product development and operation and in many instances the impact may be adverse and may 
be  material.  Any  potential  impact  to  our  results  of  operations  will  depend  to  a  large  extent  on  future  developments  and  new 
information that could emerge regarding the duration and severity of the COVID-19 pandemic and the actions taken by authorities and 
other entities to contain the spread or treat its impact, all of which are beyond our control. These potential impacts, while uncertain, 
could adversely affect our business and results of operation.

Various  types  of  disasters,  including  earthquakes,  fires,  floods,  riots,  acts  of  terrorism  and  pandemics,  may  also  affect  our 
manufacturing  facilities  and  computer  systems,  and  increase  our  cybersecurity  risks.  Although  we  have  business  interruption 
insurance, our facilities, including some pieces of manufacturing equipment and our computer systems, may be difficult to replace and 
could require substantial replacement lead-time. In the event our existing manufacturing facilities or computer systems are affected by 
man-made or natural disasters, including pandemics, we may have difficulty operating our business and may be unable to manufacture 
products for sale or meet customer demands or sales projections. If our manufacturing operations were curtailed or shut down entirely, 
it would seriously harm our business. Moreover, we may incur incremental costs following an unforeseen event which could adversely 
affect our results of operation.

Future  Sales  of  Shares  of  Our  Common  Stock  Could  Adversely  Affect  the  Trading  Price  of  Our  Common  Stock  and  Our 
Ability to Raise Funds in New Equity Offerings. 

Future sales of a substantial number of our shares of Common Stock or equity-related securities in the public market or privately, or 
the perception that such sales may occur, could adversely affect prevailing trading prices of our Common Stock, and could impair our 
ability to raise capital through future offerings of equity or equity-related securities. No prediction can be made as to the effect, if any, 

48

that future sales of shares of Common Stock or the availability of shares of Common Stock for future sale will have on the trading 
price of our Common Stock. 

ITEM 1B. Unresolved Staff Comments. 

Not Applicable. 

ITEM 2.

Properties. 

We own a 48,000 square foot facility which is OraSure’s primary corporate office and manufacturing facility, a 31,700 square foot 
facility  that  houses  our  sales  and  marketing,  research  and  development,  human  resources,  and  regulatory  and  quality  offices,  and  a 
33,500 square foot facility which is used for manufacturing activities. Each of these facilities is located in Bethlehem, Pennsylvania. 
We also rent additional warehouse space on an as-needed basis, including a 70,000 square foot warehouse in Bethlehem Township, 
Northampton County, Pennsylvania. In addition, our subsidiary, DNAG, leases a 35,883 square foot facility in Ottawa, Canada, which 
is  used  as  its  primary  corporate  office  and  houses  sales  and  marketing,  manufacturing,  distribution,  research  and  development, and 
regulatory and quality operations.  Our other subsidiaries, Diversigen and Novosanis, also lease facilities for their operations.

We believe that the facilities described above are adequate for our current requirements. 

ITEM 3.

Legal Proceedings. 

From time to time, we are involved in certain legal actions arising in the ordinary course of business. In management’s opinion, the 
outcomes  of  such  actions,  either  individually  or  in  the  aggregate,  are  not  expected  to  have  a  material  adverse  effect  on  our  future 
financial position or results of operations. 

On February 6, 2017, DNAG entered into a settlement and license agreement (the “Settlement Agreement”) in order to settle certain 
patent  infringement  and  breach  of  contract  litigation  against  Ancestry.comDNA,  LLC  (“Ancestry”)  and  its  contract  manufacturer.  
This litigation was related to a saliva DNA collection device sold by Ancestry that was similar to products sold by DNAG.  Under the 
terms  of  the  Settlement  Agreement,  DNAG  and  Ancestry  agreed  to  certain  procedures  for  considering  whether  future  versions  of 
Ancestry’s saliva DNA collection product are covered by the DNAG patents licensed to Ancestry (the “Licensed Patents”) and thus 
subject  to  ongoing  royalties  under  the  Settlement  Agreement.  A  dispute  arose  among  the  parties  regarding  whether  certain  new 
Ancestry  products  are  covered  by  the  Licensed  Patents.    Pursuant  to  the  terms  of  the  Settlement  Agreement,  a  binding  arbitration 
proceeding was commenced to resolve the dispute.  In February 2020, an arbitration panel issued a decision finding that the future 
Ancestry products do not infringe the DNAG patents asserted in the arbitration and would no longer be subject to the royalties under 
the Settlement Agreement.  

Following the completion of the arbitration, a new patent was issued to DNAG that is a continuation of a patent licensed to Ancestry 
and is thus a Licensed Patent under the Settlement Agreement.  DNAG notified Ancestry of this new patent and following discussions 
between  the  parties,  Ancestry  initiated  a  new  arbitration  proceeding  during  the  third  quarter  of  2020  pursuant  to  the  Settlement 
Agreement with respect to the applicability of the new patent to the future Ancestry products and the validity of that patent. Following 
the initiation of the arbitration by Ancestry, DNAG filed a statement of defense and an objection to the arbitration on the basis that a 
dispute between the parties has not yet occurred and therefore the alleged dispute is not sufficiently ripe to arbitrate.  An arbitration 
panel has been appointed. The parties have since engaged in settlement discussions and the commencement of the arbitration has been 
delayed. 

ITEM 4. Mine Safety Disclosures. 

Not Applicable. 

49

 
PART II 

ITEM 5.

Market  for  Registrant’s  Common  Equity,  Related  Stockholder  Matters  and  Issuer  Purchases  of  Equity 
Securities. 

Market Information 

Our Common Stock is listed for trading on the Global Select Market tier of The Nasdaq Stock Market LLC (“NASDAQ”) under the 
symbol “OSUR”.   On February 22, 2021, there were 305 holders of record and approximately 37,295 holders in street name of our 
Common Stock, and the closing price of our Common Stock was $10.83 per share. 

Dividends 

We have never paid any cash dividends and our Board of Directors does not anticipate paying cash dividends in the foreseeable future. 
We intend to retain any future earnings to provide funds for the operation and expansion of our business. 

Share Repurchases and Retirements 

Period

Total number of 
shares 
purchased

Average price 
paid per Share  

Maximum 
number (or 
approximate 
dollar value) of 
shares that may 
yet be 
repurchased 
under the plans 
or programs (1, 2)  

Total number of 
shares 
purchased as 
part of publicly 
announced plans 
or programs

October 1, 2020- October 31, 2020 ..........................................   
November 1, 2020 - November 30, 2020 .................................   
December 1, 2020 - December 31, 2020 ..................................   

—   
—   
1,083   
1,083   

—     
—     
11.60     

—    $ 11,984,720 
—    $ 11,984,720 
—    $ 11,984,720 
—       

(1) 

(2) 

On August 5, 2008, our Board of Directors approved a share repurchase program pursuant to which we are permitted to acquire 
up to $25.0 million of outstanding shares. This share repurchase program may be discontinued at any time. 
This column represents the amount that remains available under the $25.0 million repurchase plan, as of the period indicated. 
We have made no commitment to purchase any shares under this plan. 

 Performance Graph 

The  performance  graph  set  forth  below  shall  not  be  deemed  “soliciting  material”  or  “filed”  for  purposes  of  Section 18  of  the 
Securities Exchange Act of 1934, as amended (the “Exchange Act”), or otherwise subject to liability under that Section. This graph 
will not be deemed “incorporated by reference” into any filing under the Securities Act of 1933, as amended, or the Exchange Act, 
whether such filing occurs before or after the date hereof, regardless of any general incorporation language in such filing. 

The following graph compares the cumulative total returns to investors in the Company’s Common Stock, the NASDAQ Composite 
Index  and  the  NASDAQ  Biotechnology  Index  for  the  period  from  December 31,  2015  through  December 31,  2020.  The  graph 
assumes that $100 was invested on December 31, 2015 in the Company’s Common Stock and in each of the above-mentioned indices, 
and that all dividends, if any, were reinvested. 

50

 
 
   
 
   
 
     
   
     
       
       
 
   
   
   
 
   
     
     
 
The  NASDAQ  Composite  Index  was  chosen  because  it  is  a  broad  index  of  companies  whose  equity  securities  are  traded  on 
NASDAQ.  The  NASDAQ  Biotechnology  Index  was  chosen  because  it  includes  a  number  of  our  competitors.  Stockholders  are 
cautioned that the graph shows the returns to investors only as of the dates noted and may not be representative of the returns for any 
other past or future period. 

*

$100 invested on 12/31/15 in stock or index, including reinvestment of dividends.  

COMPARISON OF 5 YEAR CUMULATIVE TOTAL RETURN*
Among OraSure Technologies, Inc., the NASDAQ Composite Index 
and the NASDAQ Biotechnology Index

$350

$300

$250

$200

$150

$100

$50

$0

12/15

12/16

12/17

12/18

12/19

12/20

OraSure Technologies, Inc.

NASDAQ Composite

NASDAQ Biotechnology

*$100 invested on 12/31/15 in stock or index, including reinvestment of dividends.
Fiscal year ending December 31.

Fiscal year ending December 31,
2019
2016

2017

2018

2020

2015

OraSure Technologies, Inc..............   100.00   136.34   292.86   181.37   124.69   164.36 
NASDAQ Composite .......................   100.00   108.87   141.13   137.12   187.44   271.64 
NASDAQ Biotechnology .................   100.00    78.65    95.67    87.19   109.08   137.90  

Securities Authorized for Issuance Under Equity Compensation Plans 

For  certain  information  concerning  securities  authorized  for  issuance  under  our  equity  compensation  plan,  see  Item  12,  “Security 
Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters.” 

51

 
 
 
 
 
   
   
   
   
   
 
 
 
ITEM 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations. 

Statements  below  regarding  future  events  or  performance  are  “forward-looking  statements”  within  the  meaning  of  the  Private 
Securities Litigation Reform Act of 1995. Our actual results could be quite different from those expressed or implied by the forward-
looking  statements.  Factors  that  could  affect  results  are  discussed  more  fully  under  the  Item  1A,  entitled  “Risk  Factors,”  and 
elsewhere in this Annual Report. Although forward-looking statements help to provide complete information about us, readers should 
keep in mind that forward-looking statements may not be reliable. Readers are cautioned not to place undue reliance on the forward-
looking statements. We undertake no duty to update any forward-looking statements made herein after the date of this Annual Report. 

The  following  discussion  should  be  read  in  conjunction  with  the  consolidated  financial  statements  contained  herein  and  the  notes 
thereto, along with the Section entitled “Critical Accounting Policies and Estimates,” set forth below. This section of this Form 10-K 
generally discusses 2020 and 2019 items and year-to-year comparisons between 2020 and 2019.  Discussion of 2018 items and year-
to-year comparisons between 2019 and 2018 that are not included in this Form 10-K can be found in “Management’s Discussion and 
Analysis of Financial Condition and Results of Operations” in Part II, Item 7 of the Company’s Annual Report on Form 10-K for the 
year ended December 31, 2019.

Overview and Business Segments 

The overall goal of our Company is to empower the global community to improve health and wellness by providing access to accurate 
essential information. Our business consists of two segments: our “Diagnostics” segment, which was previously named “OSUR” and 
our “Molecular Collection Systems” segment, which was previously named “DNAG.” Our Diagnostics business primarily consists of 
the  development,  manufacture,  marketing  and  sale  of  oral  fluid  diagnostic  products  and  specimen  collection  devices  using  our 
proprietary technologies, as well as other diagnostic products including immunoassays and other in vitro diagnostic tests that are used 
on  other  specimen  types.  Our  Molecular  Solutions  business  consists  of  the  manufacture  and  sale  of  kits  that  are  used  to  collect, 
stabilize,  transport  and  store  biological  samples  of  genetic  material  for  molecular  testing  in  the  consumer  genetic,  clinical  genetic, 
academic  research,  infectious  disease  diagnostics,  pharmacogenomics,  personalized  medicine,  microbiome  and  animal  genetics 
markets.  Our  collection  kits  are  also  used  for  the  collection  of  first-void  urine  for  liquid  biopsy  in  the  prostate  and  bladder  cancer 
markets  and  in  the  sexually  transmitted  infection  screening  market.  In  addition,  our  Molecular  Solutions  business  provides 
microbiome laboratory and bioinformatics services. 

The Diagnostics business includes tests for diseases including HIV and Hepatitis C that are performed on a rapid basis at the point of 
care and tests that are processed in a laboratory. These products are sold in the United States and internationally to various clinical 
laboratories,  hospitals,  clinics,  community-based  organizations,  and  other  public  health  organizations,  distributors,  government 
agencies, physicians’ offices, and commercial and industrial entities. Our HIV product is also sold in a consumer-friendly format in 
the  over-the-counter  (“OTC”)  market  in  the  U.S.  and  as  a  self-test  to  individuals  in  a  number  of  other  countries.  Our  Diagnostics 
business includes the operations of UrSure, Inc. (“UrSure”), which was acquired and merged into OraSure in 2020. This part of the 
business  develops  and  commercializes  products  that  measure  adherence  to  HIV  medications  including  pre-exposure 
prophylaxis  or  PrEP,  the  daily  medication  to  prevent  HIV,  and  anti-retroviral  medications  to  suppress  HIV.  These 
products include laboratory-based tests that can measure levels of the medication in a patient’s urine or blood, as well as 
point of care products currently in development. We also previously manufactured and sold medical devices used for the removal 
of benign skin lesions by cryosurgery or freezing. We sold the assets associated with our cryosurgical systems business to a third party 
in August 2019. 

Our Molecular Solutions business is operated by our subsidiaries, DNA Genotek Inc. (“DNAG”), Diversigen, Inc. (“Diversigen”) and 
Novosanis  NV  (“Novosanis”). In  this  business,  we  manufacture  and  sell  kits  that  are  used  to  collect,  stabilize,  transport  and  store 
biological sample of genetic material for molecular testing.  Our products are used for academic research and commercial applications, 
including  ancestry,  disease  risk  management,  lifestyle  and  animal  testing.    Included  in  the  disease  risk  management  area  are 
pharmacogenomics  testing,  hereditary  disease  screening,  prenatal  or  cancer  screening,  population  health  initiatives  and  other 
molecular  testing  using  DNA  or  RNA  for  diagnosis  of  acute  disease.    We  also  sell  research  use  only  collection  products  into  the 
microbiome market. We offer our customers a suite of genomics and microbiome services that range from package customization and 
study design optimization to extraction, analysis and reporting services. The microbiome laboratory and bioinformatics services are 
provided by Diversigen, which includes the operations of CoreBiome, Inc. (“CoreBiome”), a subsidiary we acquired in early 2019.  
CoreBiome and Diversigen were merged together in 2020.  Novosanis manufactures and sells the Colli-Pee® collection device for the 
volumetric collection of first-void urine for use in research, screening and diagnostics in the liquid biopsy and sexually transmitted 
infection markets.  Our Molecular Solutions business serves customers in many countries worldwide, including many leading research 
universities and hospitals.

52

Recent Developments 

Impact of COVID-19 

In March 2020, the World Health Organization declared the novel coronavirus (“COVID-19”) a global pandemic. This contagious disease 
outbreak,  which  has  continued  to  spread,  has  adversely  affected  workforces,  economies,  and  financial  markets  globally,  leading to  an 
economic downturn. It is not possible for us to predict the duration or magnitude of the outbreak’s effects on our business or results of 
operations at this time.  During 2020, traditional HIV and HCV testing programs and drug testing in the workplace market were reduced 
or  terminated  as  a  result  of  the  various  “stay-at-home”  orders  and  social  distancing  guidelines  issued  by  federal,  state  and  local 
governments  to  contain  the  spread  of  the  COVID-19  pandemic  in  the  United  States.  On  the  international  front,  we  experienced  some 
reductions and stoppages of professional HIV and HCV testing in Europe and Asia due to the pandemic and delays with international 
shipments due to a reduction of customs and transportation personnel, a reduced number of air flights and shipping congestion. In our 
molecular segment, clinical and research work during the year, particularly in the academic market, has reduced demand for our products. 
These trends had a material impact on our results of operations during 2020 and we believe they will continue to have a material and 
adverse impact on the revenues of certain parts of our business for an indeterminate time period, depending on the duration and severity 
of the COVID-19 pandemic. 

We  also  believe  there  are  potentially  significant  opportunities  for  increased  revenues  as  a  result  of  the  pandemic.  During  2020,  we 
began selling our saliva collection devices for use in molecular COVID-19 testing. In addition, we are developing and will be seeking 
EUA of a rapid COVID-19 antigen test and a laboratory-based oral fluid SARS-CoV-2 antibody test. A description of these products 
can be found in the “Business” section of Part I one of this Annual Report.

In  2020,  we  generated  additional  revenues  of  approximately  $49.8  million  from  sales  of  our  molecular  collection  devices  related  to 
COVID-19 testing during the year.  In the U.S., public health customers are purchasing increased quantities of our OraQuick® In-Home 
HIV  Test  in  order  to  permit  continued  HIV  testing  while  allowing  clients  and  patients  to  adhere  to  “stay-at-home”  and  social 
distancing  requirements.  In  addition,  we  are  seeing  increased  demand  for  our  molecular  collection  products  from  customers  who 
conduct both saliva and blood-based testing. As it becomes increasingly difficult to collect blood in clinics or healthcare settings, these 
customers are increasingly relying on the saliva collection alternative. However, the degree to which these and other opportunities will 
offset the negative trends caused by the COVID-19 pandemic in future periods cannot be predicted with certainty.  

Public Offering

In June 2020, the Company completed the issuance and sale of 9,200,000 shares of its Common Stock. The price to the public in the 
offering was $11.00 per share, with net proceeds from the offering equaling approximately $95.0 million after deducting underwriting 
discounts and offering expenses paid by the Company.

UrSure Acquisition

On  July  22,  2020,  the  Company  acquired  all  of  the  outstanding  stock  of  UrSure,  pursuant  to  the  terms  of  a  merger  agreement. 
Subsequently  in  December  2020,  UrSure  was  merged  into  OraSure.    The  activities  of  this  line  of  business  are  described  in  the 
“Business”  section  of  Part  I  of  this  Annual  Report.    The  acquisition  of  UrSure  supports  our  strategy  of  expanding  our  product 
offerings  to  include  additional  diagnostic  products  particularly  point-of-care  tests,  that  complement  our  current  infectious  disease 
portfolio and pipeline. We used cash of $3.0 million to pay for this acquisition and have incurred a total of $393,000 of acquisition 
related  costs,  including  accounting,  legal,  and  other  professional  fees,  all  of  which  were  expensed  and  reported  as  a  component  of 
general and administrative expense in the consolidated statement of income for the year ended December 31, 2020.

Current Consolidated Financial Results 

During  the  year  ended  December  31, 2020,  our  consolidated  net  revenues  increased  11%  to  $171.7  million,  compared  to  $154.6 
million for the year ended December 31, 2019. Net product and services revenues during the year ended December 31, 2020 increased 
12% when compared to the same period of 2019, due to the inclusion of product revenues associated with COVID-19 testing, higher 
international sales of our OraQuick® HIV Self-Test, and higher laboratory services revenues. Partially offsetting these increases were 
lower sales of our genomics, HCV, risk assessment, domestic HIV and microbiome products and the absence of cryosurgical sales as a 
result of the divestiture of our cryosurgical systems business in August 2019. Other revenues for the year ended December 31, 2020 
were $5.3 million compared to $6.5 million in the same period of 2019. This decline was largely due to lower royalty income partially 
offset  by  increased  revenues  from  funded  research  and  development  associated  with  the  development  of  our  adherence  tests  and 
COVID-19 products. 

53

Our consolidated net loss for the year ended December 31, 2020 was $14.9 million, or $(0.22) per share on a fully diluted basis, compared to 
consolidated net income of $16.7 million, or $0.27 per share on a fully diluted basis, for the year ended December 31, 2019. Results for the 
year ended December 31, 2020 included a $1.1 million non-cash pre-tax gain associated with the change in the fair value of acquisition-
related contingent consideration and $393,000 of acquisition related transaction costs associated with the UrSure acquisition, which together 
accounted  for  approximately  $0.01  per  share.  Results  for  the  year  ended  December  31, 2019  included  a  pre-tax  gain  on  the  sale  of  our 
cryosurgical  systems  business  of  $10.2  million,  $664,000  of  non-cash  pre-tax  income  associated  with  the  change  in  the  fair  value  of 
acquisition-related contingent consideration and $1.8 million of acquisition-related transaction costs.  The combined net impact of these items 
increased earnings per share by approximately $0.14 in 2019. Results for the full-year 2020 also reflect the significant increase in spending 
associated with the development of our COVID-19 products.

Cash  provided  by  operating  activities  during  the  years  ended  December  31, 2020  and  2019  was  $5.8  million  and  $9.8  million, 
respectively. As of December 31, 2020, we had $257.1 million in cash, cash equivalents, and available-for-sale securities, compared to 
$189.8 million at December 31, 2019.

Results of Operations 

YEAR ENDED DECEMBER 31, 2020 COMPARED TO DECEMBER 31, 2019

CONSOLIDATED NET REVENUES 

The table below shows a breakdown of total net revenues (dollars in thousands) generated by each of our business segments. 

  Years Ended December 31,
  Dollars
  2020

  2019

  % Change

  Percentage of Total Net Revenues  
  2020

  2019

Diagnostics .........................................................................   $63,601
Molecular Solutions ...........................................................   102,780
Net product and service revenues .................................   166,381

Other...................................................................................   5,340

Net revenues .................................................................   $171,721

  $77,259
  70,814
  148,073
  6,532
  $154,605

  (18)
  45
  12
  (18)
  11

%  37
  60
  97
  3
%  100

%  50
  46
  96
  4
%  100

%

%

Consolidated net product and services revenues increased 12% to $166.4 million for the year ended December 31, 2020 from $148.1 
million for 2019 due to the inclusion of product revenues associated with COVID-19 testing from our Molecular Solutions segment 
coupled with increased international sales of our OraQuick® HIV Self-Test and higher laboratory services revenues.  These increases 
were partially offset by lower sales of our genomics, HCV, risk assessment, domestic HIV, and microbiome products and the absence 
of cryosurgical sales as a result of the divestiture of our cryosurgical systems business in August 2019. Other revenues for the year 
ended December 31, 2020 were $5.3 million compared to $6.5 million in 2019. This decline was largely due to lower royalty income 
partially offset by increased revenues from funded research and development associated with the development of our adherence tests 
and COVID-19 products. 

Consolidated net revenues derived from products sold to customers outside of the United States were $40.9 million and $47.3 million, 
or 24% and 31% of total net revenues, during the years ended December 31, 2020 and 2019, respectively. Because the majority of our 
international sales are denominated in U.S. dollars, the impact of fluctuating foreign currency exchange rates was not material to our 
total consolidated net revenues.

54

 
 
 
   
 
 
 
 
 
 
   
   
   
 
   
 
   
 
 
 
 
 
 
 
 
 
 
Net Revenues by Segment 

Diagnostics Segment 

The table below shows the amount of total net revenues (dollars in thousands) generated by our Diagnostics segment. 

  Years Ended December 31,

Market
Infectious disease testing ....................................................  $54,227
Risk assessment testing.......................................................    9,374
Cryosurgical systems ..........................................................    —

  Dollars
  2020

Net product revenues.....................................................    63,601

Other ...................................................................................    1,638

Net revenues..................................................................  $65,239

Percentage 
Revenues

of  Total  Net 

    2019
    $58,016
      12,189
      7,054
      77,259
      966
    $78,225

    % Change
      (7
      (23
      (100
      (18
      70
      (17

  2020
) %    83
    14
)  
    0
)  
    97
)  
    3
) %    100

  2019
  %    74
    16
    9
    99
    1
  %    100

  %

  %

Infectious Disease Testing Market 

Sales  to  the  infectious  disease  testing  market  decreased  7%  to  $54.2  million  in  2020  from  $58.0  million in  2019.  This  decrease 
resulted  from  lower  world-wide  sales  of  our  OraQuick®  HCV  products  and  lower  domestic  sales  of  our  OraQuick®  HIV  products 
partially offset by higher international sales of our OraQuick® HIV products.

The table below shows a breakdown of our total net OraQuick® HIV and HCV product revenues (dollars in thousands) during 2020 
and 2019. 

  Years Ended December 31,
  2020

Market
Domestic HIV .........................................................................  $15,184
International HIV ....................................................................    29,040
Net HIV revenues ..............................................................    44,224
Domestic HCV ........................................................................    4,793
International HCV...................................................................    3,655
Net HCV revenues.............................................................    8,448
Net OraQuick®  revenues.......................................................  $52,672

    2019
    $17,984
      25,108
      43,092
      8,108
      4,864
      12,972
    $56,064

    % Change
      (16
      16
      3
      (41
      (25
      (35
      (6

)%

) 
) 
) 
)%

Domestic OraQuick® HIV sales decreased 16% to $15.2 million for the year ended December 31, 2020 from $18.0 million for the year 
ended  December 31,  2019.  This  decrease  was  primarily  the  result  of  the  decline  in  domestic  HIV  testing  in  public  health  clinics, 
hospitals  and  doctors’  offices  resulting  from  the  COVID-19  pandemic  partially  offset  by  increased  sales  for  our  at-home  test  as  a 
result of the COVID-19 pandemic.  

International  sales  of  our  OraQuick®  HIV  products  during  2020  increased  16%  to  $29.0  million  from  $25.1  million  in  2019.  This 
increase was largely due to higher sales of our OraQuick® HIV Self-Test in Africa. 

Domestic  OraQuick®  HCV  sales  decreased  41%  to  $4.8  million  in  2020  from  $8.1 million  in  2019.  International  OraQuick®  HCV 
sales  decreased  25%  to  $3.7  million  in  2020  from  $4.9  million  in  2019.    The  declines  in  HCV  sales  in  both  the  domestic  and 
international markets were due to the closure of testing programs due to the COVID-19 pandemic. 

Risk Assessment Market 

Sales to the risk assessment market decreased 23% to $9.4 million for the year ended December 31, 2020 from $12.2 million for the 
year ended December 31, 2019 due to unemployment and reductions in workplace and insurance testing programs resulting from the 
COVID-19 pandemic. 

Cryosurgical Systems Market 

In August 2019, we sold our cryosurgical systems line of business and as such have stopped recording revenues associated with that 
business since the third quarter of 2019.

55

 
   
 
       
   
 
   
   
   
   
   
   
   
   
   
   
   
   
   
 
   
   
   
   
Other revenues 

Other revenues for the year ended December 31, 2020 increased 70% to $1.6 million from $966,000 for the year ended December 31, 
2019.  Revenue  associated  with  funding  of  our  research  and  development  efforts  increased  to  $1.6  million for  the  year  ended 
December  31, 2020  from  $705,000 for  the  year  ended  December  31,  2019  as  new  grants  for  COVID-19  funded  projects  and 
adherence test research and development funding were partially offset by the wind-down of efforts to develop our rapid Ebola test. 
Other revenues for the year ended December 31, 2020 also included $68,000 in reimbursement of certain costs under our charitable 
support agreement with the Gates Foundation compared to $261,000 for the year ended December 31, 2019.

Molecular Solutions Segment 

The table below shows a breakdown of total net revenues (dollars in thousands) generated by our Molecular Solutions segment for the 
year ended December 31, 2020 and 2019.

  Years Ended December 31,
  2020

Market
Genomics ................................................................................................  $37,141
Microbiome.............................................................................................    6,156
COVID-19 ..............................................................................................    49,802
Laboratory services.................................................................................    9,564
Other product revenues...........................................................................    117

Net molecular product and services revenues ...................................    102,780

Other .......................................................................................................    3,701

Net revenues......................................................................................  $106,481

    2019
    $56,200
      7,172
      —
      6,767
      675
      70,814
      5,566
    $76,380

    % Change
      (34
      (14
    N/A
      41
      (83
      45
      (34
      39

) %
)  

)  

)  
  %

Sales of our genomics products decreased 34% to $37.1 million in 2020 compared to $56.2 million in 2019, largely due to the timing 
of orders placed by one of our largest genomics customer and the reduction in genomics testing due to the COVID-19 pandemic.

Microbiome revenues decreased 14% to $6.2 million in 2020 compared to $7.2 million in 2019 largely due to reduced product demand 
caused by the COVID-19 pandemic.

During  2020,  we  sold  $49.8  million  of  sample  collection  devices  for  use  in  the  collection  and  transport  of  samples  for  COVID-19 
molecular testing. There were no similar sales in 2019. 

Laboratory  services  revenues  increased  41%  to  $9.6  million  in  2020  compared  to  $6.8  million  in  2019,  due  to  the  inclusion  of 
revenues generated by Diversigen which was acquired in the fourth quarter of 2019, partially offset by a decline in laboratory testing 
due to the inability of our customers to collect samples as a result of the COVID-19 pandemic.

Other revenues in 2020 decreased 34% to $3.7 million from $5.6 million in 2019 largely as a result of lower royalty income under a 
litigation settlement agreement.

56

 
   
   
   
   
   
CONSOLIDATED OPERATING RESULTS 

Consolidated  gross  profit  percentage  was  59%  for  the  year  ended  December 31,  2020  compared  to  61%  for  2019.  The  decrease  in 
gross profit percentage was primarily due to lower labor utilization as we increased our manufacturing headcount with full-time and 
temporary employees to prepare for expected product production increases, increased scrap and spoilage expense and the decline in 
other revenues which contribute 100% to our gross profit percentage.  These declines in gross profit percentage were partially offset 
by a more favorable product mix. 

Consolidated operating loss in 2020 was $5.2 million, a $23.8 million decline from the $18.6 million of operating income reported in 
2019. Results in 2020 were negatively impacted by increased operating expenses related to COVID-19 product development, higher 
staffing costs and the inclusion of expenses attributable to Diversigen and UrSure. The operating loss in 2020 included $1.1 million of 
non-cash income related to the fair value change of acquisition-related contingent consideration compared to $664,000 of non-cash 
income in the comparable period of the prior year. Results in 2019 also included the pre-tax gain of $10.2 million from the sale of our 
cryosurgical systems business. 

OPERATING INCOME BY SEGMENT

Diagnostic Segment 

The gross profit percentage of the Diagnostics business was 42% in 2020 compared to 55% in 2019. This decrease is largely due to a 
less  favorable  product  mix,  lower  labor  utilization  as  we  increased  our  manufacturing  headcount  with  full-time  and  temporary 
employees to prepare for expected product production increases and increased scrap and spoilage expense.

Research  and  development  expenses  increased  75%  to  $21.3 million  in  2020  from  $12.2 million  in  2019,  largely  due  to  spending 
associated with COVID-19 product development, higher staffing costs, and the inclusion of UrSure expenses not present in 2019. 

Sales and marketing expenses increased 24% to $22.4 million in 2020 from $18.1 million in 2019, due to higher staffing costs as a 
result of increased headcount, increased commissions and the additional costs associated with the retirement of a senior executive who 
previously led our Diagnostics Business Unit and the on-boarding costs of his successor.  Also contributing to the higher sales and 
marketing expense was an increase in our reserve for uncollectible accounts associated primarily with one of our distributors located 
in Africa, higher marketing costs and the inclusion of UrSure expenses not present in 2019. These increases were partially offset by 
lower travel and trade show costs due to the COVID-19 pandemic. 

General and administrative expenses increased 25% to $28.1 million in 2020 from $22.5 million in 2019 largely due to higher staffing 
costs  associated  with  increased  employee  bonuses  as  a  result  of  our  strong  financial  performance  in  2020  and  an  increase  in 
headcount,  and  the  inclusion  of  $393,000  in  transaction  costs  associated  with  the  UrSure  acquisition.    These  increases  were  partially 
offset  by  a  decline  in  professional  fees  related  to  business  development  activities  and  lower  travel  expenses  due  to  the  COVID-19 
pandemic.

Operating  income  in  2019  also  included  a  $10.2  million  pre-tax  gain  on  the  sale  of  our  cryosurgical  systems  business.  In  August 
2019, we sold all assets necessary to operate this line of business to a third party for $12.0 million. The $10.2 million gain includes the 
$12.0 million proceeds received net of the fair value of the assets sold, which consisted of inventory and fully-depreciated fixed assets, 
the legal fees associated with the transaction, and a value attributed to the transition services. 

All  of  the  above  contributed  to  an  operating  loss  of  $43.2  million  for  2020,  which  included  non-cash  charges  of  $3.3 million  for 
depreciation and amortization and $6.0 million for stock-based compensation. The Diagnostics segment operating loss also included a 
non-cash pre-tax gain of $989,000 associated with the change in the fair value of acquisition-related contingent consideration.

Molecular Solutions Segment 

The  gross  profit  percentage  of  the  Molecular  Solutions  segment  was  70%  in  2020  compared  to  68%  in  2019.  This  increase  was 
attributable to a more favorable product mix as a result of higher sales of higher gross profit products and services partially offset by 
the decline in other revenues which contribute 100% to the gross profit percentage. 

Research and development expenses increased 31% to $9.8 million in 2020 from $7.5 million in 2019 due higher staffing costs and 
the inclusion of research and development expenses incurred by Diversigen for the full year in 2020 compared to two months in 2019. 

Sales and marketing expenses decreased 12% to $12.0 million in 2020 compared to $13.7 million in 2019 largely due to a prior period 
increase in our reserve for uncollectible accounts associated primarily with a receivable from a large Chinese genomics customer and 

57

a decline in travel expenses due to the COVID-19 pandemic. These decreases were partially offset by increased staffing costs and a 
full year of expenses incurred by Diversigen compared to two months in 2019. 

General and administrative expenses increased 14% to $14.6 million in 2020 compared to $12.8 million in 2019, due to the inclusion 
of expenses incurred by Diversigen for in the full year 2020 compared to two months in 2019.

All  of  the  above  contributed  to  operating  income  of  $38.0 million  for  2020,  which  included  non-cash  charges  of  $6.0 million  for 
depreciation  and  amortization  and  $1.1  million  for  stock-based  compensation.  The  Molecular  Solutions  segment  operating  income 
also  included  a  non-cash  pre-tax  gain  of  $110,000  associated  with  the  change  in  the  fair  value  of  acquisition-related  contingent 
consideration.

CONSOLIDATED INCOME TAXES 

We continue to believe the full valuation allowance established in 2008 against our total U.S. deferred tax asset is appropriate as the 
facts and circumstances necessitating the allowance have not changed. For the year ended December 31, 2020, we recorded a federal 
tax benefit of $637,000 and a state income tax benefit of $156,000 compared to a federal tax benefit of $832,000 and state income tax 
expense  of  $892,000  for  the  year  ended  December 31,  2019.  Foreign  income  tax  expense  of  $12.2 million  and  $4.6  million  was 
recorded in 2020 and 2019, respectively.  The increase in income tax  expense was largely a result of the increase  in income before 
taxes generated by our Canadian subsidiary. 

Liquidity and Capital Resources 

Cash and cash equivalents ..........................................................  $160,802
Available for sale securities........................................................    96,317
Working capital ..........................................................................    242,404

   $75,715
     114,043
     191,837

  December 31,
  2020
  (In thousands)

    2019

Our cash and cash equivalents and available-for-sale securities increased to $257.1 million at December 31, 2020 from $189.8 million 
at December 31, 2019. Our working capital increased to $242.4 million at December 31, 2020 from $191.8 million at December 31, 
2019.

During 2020, net cash provided by operating activities was $5.8 million. Our net loss of $14.9 million included non-cash charges for 
depreciation  and  amortization  expense  of  $9.4  million,  stock-based  compensation  expense  of  $7.1  million,  a  provision  for  doubtful 
accounts  of  $941,000,  and  other  net  non-cash  charges  of  $165,000.  Operating  activities  also  included  a  $1.1  million  non-cash  gain 
associated with the change in the estimated fair value of contingent consideration and a $496,000 contingent consideration payment 
representing the excess of the total contingent consideration payment made during the first quarter of 2020 over the fair value of the 
liability  estimated  at  the  time  of  acquisition.  Sources  of  cash  generated  from  our  working  capital  accounts  included  a  $7.4  million 
increase in accounts payable due to the timing of invoice payments, a $7.3 million increase in accrued expenses associated with the 
accruals for current year management incentive bonuses and higher sales tax payable, and a $1.1 million increase in deferred revenue 
associated  with  customer  prepayments.  Offsetting  these  sources  of  cash  were  an  increase  in  inventory  of  $8.6  million  to  meet 
anticipated demand to support COVID-19 testing programs and to fulfill international HIV sales.  An additional use of cash was a $2.3 
million increase in accounts receivable largely resulting from an increase in product orders placed during the fourth quarter of 2020.   

Net cash used in investing activities was $14.0 million for the year ended December 31, 2020, which reflects $90.1 million used to 
purchase investments, $26.7 million used to acquire property and equipment largely associated with increasing capacity in anticipation 
of increased product demand in 2021, $3.0 million to acquire UrSure, and $2.3 million used to purchase certain patent and product 
rights from a third party, partially offset by $107.7 million in proceeds from the maturities and redemptions of investments.

Net cash provided by financing activities was $92.5 million for the year ended December 31, 2020, which largely resulted from the 
$95.0 million in net proceeds from the issuance of common stock in connection with a public offering and proceeds of stock option 
exercises  of  $3.2  million,  partially  offset  by  $3.0  million  used  for  payment  of  an  acquisition-related  contingent  consideration 
obligation and $2.1 million used for the repurchase of common stock to satisfy withholding taxes related to the vesting of restricted 
shares awarded to our employees. 

We  expect  current  balances  of  cash  and  cash  equivalents  and  available-for-sale  securities  to  be  sufficient  to  fund  our  current  and 
foreseeable  operating  and  capital  needs.  Our  cash  requirements,  however,  may  vary  materially  from  those  now  planned  due  to  many 

58

  
 
 
 
 
 
 
 
 
factors, including, but not limited to, the scope and timing of future strategic acquisitions, the progress of our research and development 
programs,  the  scope  and  results  of  clinical  testing,  the  cost  of  any  future  litigation,  the  magnitude  of  capital  expenditures,  including 
continued  investment  to  expand  our  capacity  to  manufacture  products  for  COVID-19  testing,  changes  in  existing  and  potential 
relationships with business partners, the timing and cost of obtaining regulatory approvals, the timing and cost of future stock purchases, 
the costs involved in obtaining and enforcing patents, proprietary rights and any necessary licenses, the cost and timing of expansion of 
sales and marketing activities, market acceptance of new products, competing technological and market developments, the impact of the 
current economic environment and other factors. In addition, $99.4 million or 39% of our $257.1 million in cash, cash equivalents and 
available-for-sale  securities  at  December  31,  2020  as  held  by  to  our  Canadian  subsidiary,  DNAG.  Repatriation  of  such  cash  into  the 
United States exceeding certain levels could have adverse tax consequences.

Critical Accounting Policies and Estimates 

This Management’s Discussion and Analysis of Financial Condition and Results of Operations discusses our consolidated financial 
statements, which have been prepared in accordance with accounting principles generally accepted in the United States of America. 
The  preparation  of  these  financial  statements  requires  that  we  make  judgements  and  estimates  that  affect  the  reported  amounts  of 
assets and liabilities, the disclosure of contingent assets and liabilities at the date of the financial statements, and the reported amounts 
of revenues and expenses during the reporting period. We base our judgments and estimates on historical experience and on various 
other  factors  that  are  believed  to  be  reasonable  under  the  circumstances,  the  results  of  which  form  the  basis  for  making  judgments 
about the carrying value of assets and liabilities that are not readily apparent from other sources. Actual results may differ from these 
estimates under different assumptions or conditions. 

Our significant accounting policies are described in Note 2 of the Notes to the consolidated financial statements included in Item 15 of 
this Annual Report. We consider the following accounting policies, which have been discussed with our Audit Committee, to be most 
critical in understanding the more complex judgments that are involved in preparing our financial statements and the uncertainties that 
could impact our results of operations, financial condition and cash flows. 

Revenue Recognition. 

Product sales.  Revenue from product sales is recognized upon transfer of control of a product to a customer based on an amount that 
reflects the consideration we are entitled to, net of allowances for any discounts or rebates.    

We  generally  do  not  grant  product  return  rights  to  our  customers,  except  for  (i)  warranty  returns,  (ii)  return  rights  on  sales  of  our 
OraQuick® In-Home HIV test to the retail trade, and (iii) under the terms of a long-term contract with a genomics customer, which 
was amended in 2020 to remove the return rights provision.  

Historically, returns arising from warranty issues have been infrequent and immaterial. Accordingly, we expense warranty returns as 
incurred.

We record shipping and handling charges billed to our customers as product revenue and the related expense as cost of products sold.

Service Revenues.  Service revenues represent microbiome laboratory testing and analytical services. We recognize revenues when we 
satisfy our performance obligation for services rendered.

Arrangements  with  multiple-performance  obligations.    In  arrangements  involving  more  than  one  performance  obligation,  which 
largely applies to our service revenue stream, each required performance obligation is evaluated to determine whether it qualifies as a 
distinct performance obligation based on whether (i) the customer can benefit from the good or service either on its own or together 
with other resources that are readily available and (ii) the good or service is separately identifiable from other promises in the contract.  
The consideration under the arrangement is then allocated to each separate distinct performance obligation based on each respective 
relative stand-alone selling price.  The estimated selling price of each deliverable is determined using an observable cost plus margin 
approach.  The consideration allocated to each distinct performance obligation is recognized as revenue when control is transferred for 
the related goods or services or when the performance obligation has been satisfied.    

Other  revenues.    Other  revenues  consist  primarily  of  royalty  income,  funding  of  research  and  development  efforts  and  cost 
reimbursements under a charitable support agreement.  Royalties from licensees are based on third-party sales of licensed products 
and are recorded when the related third-party product sale occurs. Funding and charitable support reimbursements are recorded as the 
activities are being performed in accordance with the respective agreements. 

59

Deferred Revenue.  We record deferred revenue when funds are received prior to the recognition of the associated revenue. Deferred 
revenue as of December 31, 2020 and 2019 included customer prepayments of $3.2 million and $1.9 million, respectively. Deferred 
revenue  as  of  December  31,  2020  and  2019  also  included  $1.6  million  and  $1.8  million,  respectively,  associated  with  a  long-term 
contract that has variable pricing based on volume. The average price over the life of contract was determined based on the expected 
revenues and revenue is recognized at that rate when the product is delivered to the customer.

Financing and Payment.  Our payment terms vary by the type and location of our customer and products or services offered.  Payment 
terms  differ  by  jurisdiction  and  customer  but  payment  is  generally  required  in  a  term  ranging  from  30  to  120  days  from  date  of 
shipment or satisfaction of the performance obligation. For certain products or services and customer types, we may require payment 
before the products are delivered or services are rendered to the customer.

Practical expedients and exemptions.  Taxes assessed by governmental authorities, such as sales or value-added taxes, are excluded 
from product revenues.

Sales commissions are expensed when incurred if the amortization period is one year or less.  These costs are recorded in sales and 
marketing expense in the consolidated statements of operations.  If the amortization period exceeds one year, we defer the cost of the 
commission and expense over the life of the related sales contract.

Inventories.

Our inventories are stated at the lower of cost or net realizable value, with cost determined on a first-in, first-out basis, and include the 
cost of raw materials, labor and overhead. The majority of our inventories are subject to expiration dating, which can be extended in 
certain circumstances. We continually evaluate quantities on hand and the carrying value of our inventories to determine the need for 
reserves for excess and obsolete inventories, based on prior experience as well as estimated forecasts of product sales. We reserve for 
unidentified  scrap  or  spoilage  based  on  historical  write-off  rates.    We  also  consider  items  identified  through  specific  identification 
procedures  in  assessing  the  adequacy  of  our  reserve.  When  factors  indicate  that  impairment  has  occurred,  either  a  reserve  is 
established against the inventories’ carrying value or the inventories are completely written off, as in the case of lapsing expiration 
dates. 

During 2020, 2019, and 2018, we wrote-off inventory which had a cost of $2.6 million, $1.3 million and $1.3 million, respectively. 
These write-offs were a result of quality, scrap and product expiration issues. Although we make every effort to ensure the accuracy of 
our  forecasts  of  future  product  demand,  any  significant  unanticipated  changes  in  demand  could  have  a  significant  impact  on  the 
carrying value of our inventories and reported operating results. 

Deferred Tax Assets and Liabilities. 

At  December 31,  2020,  we  had  federal  Net  Operating  Loss  (“NOL”)  carryforwards  of  $136.3 million.  The  net  deferred  tax  assets, 
before  the  valuation  allowance,  associated  with  these  NOLs  and  other  temporary  differences  were  $35.4 million  at  December 31, 
2020. Net operating losses will begin to expire in 2021. In assessing the realizability of deferred tax assets, we consider whether it is 
more likely than not that some portion or all of the deferred tax assets will not be realized. The ultimate realization of deferred tax 
assets  is  dependent  upon  the  generation  of  future  taxable  income  during  the  period  in  which  those  temporary  differences  become 
deductible  or  the  NOLs  and  credit  carryforwards  can  be  utilized.  We  consider  the  scheduled  reversal  of  deferred  tax  liabilities, 
projected future taxable income and tax planning strategies in making this assessment. 

We currently have a full valuation allowance recorded against our total U.S. deferred tax asset as we had determined in 2008 that it 
was  more  likely  than  not  that  we  would  not  realize  the  benefits  associated  with  our  deferred  tax  assets.  Each  year,  we  continue  to 
reevaluate our valuation allowance position and believe that it is more likely than not that our U.S. deferred income tax asset will not 
be  realized.  As  such,  we  maintain  a  full  valuation  allowance  as  of  December 31,  2020  and  2019  against  our  deferred  tax  assets 
associated with the operations subject to income tax in the U.S. 

The Tax Reform Act of 1986 contains provisions under Internal Revenue Code (“IRC”) Section 382 that limit the annual amount of 
federal and state NOLs available to be used in any given year in the event of a significant change in ownership. Our ability to use our 
federal and state NOL carryforwards to offset future federal income tax obligations could be limited by changes in the ownership of 
our stock. The Company does not believe, however, that there is a Section 382 limitation that will impair our future ability to utilize 
NOLs to offset our future taxable income and the Company continues to review ownership changes on an annual basis. 

60

Business Combinations and Contingent Consideration. 

Acquired businesses are accounted for using the acquisition method of accounting, which requires that the purchase price be allocated 
to  the  net  assets  acquired  at  their  respective  fair  values.  Any  excess  of  the  purchase  price  over  the  estimated  fair  values  of the  net 
assets acquired is recorded as goodwill. Amounts allocated to contingent consideration are recorded to the balance sheet at the date of 
acquisition based on their relative fair values. The purchase price allocation requires us to make significant estimates and assumptions, 
especially at the acquisition date, with respect to intangible assets. Although we believe the assumptions and estimates we have made 
are  reasonable,  they  are  based  in  part  on  historical  experience  and  information  obtained  from  the  management  of  the  acquired 
companies and are inherently uncertain. 

We account for contingent consideration in accordance with applicable guidance provided within the business combination accounting 
guidance. As part of our consideration for our recent acquisitions, we are contractually obligated to pay certain consideration resulting 
from the outcome of future events. Therefore, we are required to update our underlying assumptions each reporting period, based on 
new developments, and record such contingent consideration liabilities at fair value until the contingency is resolved. Changes in the 
fair value of the contingent consideration liabilities are recognized each reporting period and included in our consolidated statements 
of operations.  Our estimates of fair value are based on assumptions we believe to be reasonable, but the assumptions are uncertain and 
involve  significant  judgment  by  management.    Updates  to  these  assumptions  could  have  a  significant  impact  on  our  results  of 
operations  in  any  given  period  and  any  updates  to  the  fair  value  of  the  contingent  consideration  could  differ  materially  from  the 
previous estimates.

Examples of critical estimates used in valuing certain intangible assets and contingent consideration include: 

• 

• 

• 

• 

future expected cash flows from sales and acquired developed technologies;

the  acquired  company's  trade  name  and  customer  relationships  as  well  as  assumptions  about  the  period  of  time  the 
acquired trade name and customer relationships will continue to be used in the combined company's portfolio;

the probability of meeting the future events; and

discount rates used to determine the present value of estimated future cash flows.

These estimates are inherently uncertain and unpredictable, and if different estimates were used the purchase price for the acquisition 
could be allocated to the acquired assets and liabilities differently from the allocation that we have made. In addition, unanticipated 
events and circumstances may occur, which may affect the accuracy or validity of such estimates, and if such events occur we may be 
required  to  record  a  charge  against  the  value  ascribed  to  an  acquired  asset  or  an  increase  in  the  amounts  recorded  for  assumed 
liabilities. 

ITEM 7A. Quantitative and Qualitative Disclosures About Market Risk. 

The information with respect to forward-looking statements within “Management’s Discussion and Analysis of Financial Condition 
and Results of Operations” of this Annual Report is incorporated herein by reference.

We do not hold any amounts of derivative financial instruments or derivative commodity instruments and, accordingly, we have no 
material derivative risk to report under this Item. 

As  of  December  31,  2020,  we  did  not  have  any  foreign  currency  exchange  contracts  or  purchase  currency  options  to  hedge  local 
currency  cash  flows.  Sales  denominated  in  foreign  currencies  comprised  5.0%  of  our  total  revenues  for  the  year  ended  December 
31, 2020. We do have foreign currency exchange risk related to our operating subsidiaries in Canada and in Belgium.  The principal 
foreign currencies in which we conduct business are the Canadian dollar and the Euro. Fluctuations in the exchange rate between the 
U.S.  dollar  and  these  foreign  currencies  could  affect  year-to-year  comparability  of  operating  results  and  cash  flows.  Our  foreign 
subsidiaries had net assets, subject to translation, of $161.5 million in U.S. Dollars, which are included in the Company’s consolidated 
balance sheet as of December 31, 2020. A 10% unfavorable change in the Canadian-to-U.S. dollar and Euro-to-U.S. dollar exchange 
rates would have decreased our comprehensive income by approximately $12.9 million in the year ended December 31, 2020.

ITEM 8.

Financial Statements and Supplementary Data. 

Information with respect to this Item is contained in our Consolidated Financial Statements included in Item 15 of this Annual Report 
on Form 10-K. 

61

ITEM 9.

Changes in and Disagreements with Accountants on Accounting and Financial Disclosure. 

Not applicable. 

ITEM 9A. Controls and Procedures. 

(a) Evaluation of Disclosure Controls and Procedures. 

The  Company’s  management,  with  the  participation  of  the  Company’s  Chief  Executive  Officer  and  Chief  Financial  Officer,  has 
evaluated the effectiveness of the Company’s disclosure controls and procedures (as defined in Rules 13a-15(e) and 15d-15(e) of the 
Securities Exchange Act of 1934) as of December 31, 2020. Based on that evaluation, the Company’s management, including such 
officers,  concluded  that  as  of  December 31,  2020  the  Company’s  disclosure  controls  and  procedures  were  effective  to  provide 
reasonable  assurance  that  information  required  to  be  disclosed  by  the  Company  in  the  reports  that  we  file  or  submit  under  the 
Securities Exchange Act of 1934 is accumulated  and communicated to  the Company’s management, including the Chief Executive 
Officer and Chief Financial Officer, to allow timely decisions regarding required disclosure and is recorded, processed, summarized, 
and reported within the time periods specified in the rules and forms of the Securities and Exchange Commission. 

(b) Management’s Report on Internal Control Over Financial Reporting. 

The Company’s management is responsible for establishing and maintaining adequate internal control over financial reporting, as such 
term  is  defined  in  Rule  13a-15(f)  and  15d-15(f)  under  the  Securities  Exchange  Act  of  1934.  Under  the  supervision  and  with  the 
participation of the Company’s management, including our principal executive officer and principal financial officer, we conducted an 
evaluation of the effectiveness of our internal control over financial reporting based on the framework in Internal Control - Integrated 
Framework  (2013) issued  by  the  Committee  of  Sponsoring  Organizations  of  the  Treadway  Commission.  Based  on  our  evaluation 
under the framework, our management concluded that our internal control over financial reporting was effective 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 as of December 31, 2020. 

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 because of changes in 
conditions, or that the degree of compliance with the policies or procedures may deteriorate. 

The  Company  acquired  UrSure,  Inc.  during  2020,  and  management  excluded  from  its  assessment  of  the  effectiveness  of  the 
Company’s internal control over financial reporting as of December 31, 2020, the acquired company representing approximately 1.7% 
of total assets and 0.5% of total revenues of the Company as of and for the year ended December 31, 2020. Management plans to fully 
integrate the operations of these businesses into the assessment of the effectiveness of the Company’s internal control over financial 
reporting in 2021.

The  effectiveness  of  our  internal  control  over  financial  reporting  as  of  December 31,  2020  has  been  audited  by  KPMG  LLP,  an 
independent registered public accounting firm, as stated in their report, which is included below. 

(c) Changes in Internal Control Over Financial Reporting. 

There were no changes in our internal control over financial reporting during the fiscal quarter ended December 31, 2020 that have 
materially affected, or are reasonably likely to materially affect, our internal control over financial reporting. 

(d) Report of Independent Registered Public Accounting Firm. 

To the Stockholders and Board of Directors
OraSure Technologies, Inc.:

Opinion on Internal Control Over Financial Reporting

We  have  audited  OraSure  Technologies,  Inc.  and  subsidiaries' (the  Company)  internal  control  over  financial  reporting  as  of 
December 31, 2020,  based  on  criteria  established  in  Internal  Control  –  Integrated  Framework  (2013)  issued  by  the  Committee  of 
Sponsoring Organizations of the Treadway Commission. In our opinion, the Company maintained, in all material respects, effective 
internal  control  over  financial  reporting  as  of  December 31, 2020,  based  on  criteria  established  in  Internal  Control  –  Integrated 
Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission.

We  also  have  audited,  in  accordance  with  the  standards  of  the  Public  Company  Accounting  Oversight  Board  (United  States) 
(PCAOB), the consolidated balance sheets of the Company as of December 31, 2020 and 2019, the related consolidated statements of 
operations,  comprehensive  income  (loss),  stockholders’  equity,  and  cash  flows  for  each  of  the  years  in  the  three-year  period  ended 

62

December 31, 2020,  and  the  related  notes  (collectively,  the  consolidated  financial  statements),  and  our  report  dated  March 1, 2021 
expressed an unqualified opinion on those consolidated financial statements.

The  Company  acquired  UrSure,  Inc. during  2020,  and  management  excluded  from  its  assessment  of  the  effectiveness  of  the 
Company’s internal control over financial reporting as of December 31, 2020, UrSure, Inc.’s internal control over financial reporting 
associated with approximately 1.7% of total assets and 0.5% of total revenues included in the consolidated financial statements of the 
Company as of and for the year ended December 31, 2020. Our audit of internal control over financial reporting of the Company also 
excluded an evaluation of the internal control over financial reporting of UrSure, Inc.

Basis for Opinion

The Company’s management is responsible 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 Management’s Report on Internal Control 
Over Financial Reporting. Our responsibility is to express an opinion on the Company’s internal control over financial reporting based 
on  our  audit.  We  are  a  public  accounting  firm  registered  with  the  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 audit in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audit 
to obtain reasonable assurance about whether effective internal control over financial reporting was maintained in all material respects. 
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 audit also included performing such other procedures as we considered necessary in the circumstances. 
We believe that our audit provides a reasonable basis for our opinion.

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  (1)  pertain  to  the 
maintenance  of  records  that,  in  reasonable  detail,  accurately  and  fairly  reflect  the  transactions  and  dispositions  of  the  assets  of  the 
company; (2) 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  (3)  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 because of changes in 
conditions, or that the degree of compliance with the policies or procedures may deteriorate.

/s/ KPMG LLP

Philadelphia, Pennsylvania
March 1, 2021

ITEM 9B. Other Information. 

Not applicable. 

63

 
PART III 

We  have  omitted  from  Part  III  the  information  that  will  appear  in  our  Definitive  Proxy  Statement  for  our  2021Annual  Meeting  of 
Stockholders (the “Proxy Statement”), which will be filed within 120 days after the end of our fiscal year pursuant to Regulation 14A. 

ITEM 10. Directors, Executive Officers and Corporate Governance. 

Certain information required by this Item is incorporated by reference to the information under the captions “Proposal No. 1. Election 
of Directors,” “Corporate Governance - Governance Guidelines and Code of Conduct,” “Corporate Governance – Committees of the 
Board,” “Executive Officers,” and “Section 16(a) Beneficial Ownership Reporting Compliance” in the Proxy Statement. 

Our Board of Directors has adopted a Code of Business Conduct and Ethics that applies to our principal executive officer, principal 
financial  officer  and  principal  accounting  officer,  as  well  as  to  the  members  of  our  Board  of  Directors  and  our  other  officers  and 
employees.  This  Code  of  Business  Conduct  and  Ethics  is  available  on  our  website  at  www.orasure.com.  We  intend  to  satisfy  the 
amendment and waiver disclosure requirements under applicable securities regulations by posting any amendments of, or waivers to, 
the Code of Business Conduct and Ethics on our website. 

ITEM 11. Executive Compensation. 

The information required by this Item is incorporated by reference to the information under the captions “Compensation Committee 
Matters”  (including  the  “Compensation  Committee  Report”),  “Compensation  Discussion  and  Analysis,”  “Compensation  Tables,” 
“Employment  Agreements  and  Potential  Payments  Upon  Termination  or  Change  in  Control,”  and  “Director  Compensation”  in  the 
Proxy Statement. 

ITEM 12.

Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters. 

The  information  required  by  this  Item  with  respect  to  the  securities  ownership  of  certain  beneficial  owners  and  management,  and 
equity compensation plan information, is incorporated by reference to the information under the captions “Stock Ownership of Certain 
Beneficial Owners and Management” and “Equity Compensation Plan Information” in the Proxy Statement. 

ITEM 13. Certain Relationships and Related Transactions, and Director Independence. 

The information required by this Item is incorporated by reference to the information under the captions “Transactions with Related 
Persons” and “Corporate Governance - Director Independence” in the Proxy Statement. 

ITEM 14.

Principal Accountant Fees and Services. 

The information required by this Item is incorporated by reference to the information under the caption “Audit Committee Matters” in 
the Proxy Statement. 

64

 
PART IV 

ITEM 15. Exhibits and Consolidated Financial Statement Schedules. 

(a)(1) and (a)(2). Consolidated Financial Statements and Schedules. For a list of the consolidated financial statements filed herewith, 
see  the  Index  to  Consolidated  Financial  Statements  following  the  signature  page  to  this  Annual  Report.  No  schedules  are  included 
with the consolidated financial statements because the required information is inapplicable or is presented in the consolidated financial 
statements or related notes thereto. 

(a)(3). Exhibits. 

Exhibit
Number 
3.1.1

Exhibit 
Certificate of Incorporation of OraSure Technologies, Inc. is incorporated by reference to Exhibit 3.1 to the Company’s 
Registration Statement on Form S-4 (No. 333-39210), filed June 14, 2000. 

3.1.2

Certificate  of  Amendment  to  Certificate  of  Incorporation  dated  May   23,  2000  is  incorporated  by  reference  to  Exhibit 
3.1.1 to the Company’s Registration Statement on Form S-4 (No. 333-39210), filed June 14, 2000. 

3.2

4.1

10.1

10.2

10.3

10.4

10.5

10.6

10.7

10.8

10.9

Bylaws of OraSure Technologies, Inc., as amended and restated as of February 19, 2018, are incorporated by reference to 
Exhibit 3.2 to the Company’s Annual Report on Form 10-K for the year ended December 31, 2017. 

Description of Securities is incorporated by reference to Exhibit 4.1 to the Company’s Annual Report on Form 10-K for 
the year-ended December 31, 2019.

Employment Agreement dated as of January  3, 2018, between OraSure Technologies, Inc. and Stephen S. Tang, Ph.D., is 
incorporated by reference to Exhibit 10.1 to the Company’s Current Report on Form 8-K filed January 4, 2018.* 

Employment Agreement, dated as of May 4, 2018, between the Company and Roberto Cuca is incorporated by reference 
to Exhibit 10.1 to the Company’s Current Report on Form 8-K filed May 4, 2018.*

Employment  Agreement,  dated  as  of  July   1,  2004,  between  OraSure  Technologies,  Inc.  and  Jack  E.  Jerrett,  is 
incorporated by reference to Exhibit 10.7 to the Company’s Quarterly Report on Form 10-Q for the quarter ended June 30, 
2004.* 

Amendment No. 1 to Employment Agreement, dated as of December  16, 2008, between the Company and Jack E. Jerrett, 
is incorporated by reference to Exhibit 10.6 to the Company’s Current Report on Form 8-K filed December 19, 2008.* 

Amendment No. 2 to the Employment Agreement, dated as of December  15, 2010, between the Company and Jack E. 
Jerrett, is incorporated by reference to Exhibit 10.13 to the Company’s Annual Report on Form 10-K for the year ended 
December 31, 2010.* 

Amendment No. 3 to Employment Agreement, dated as of March  27, 2015, between the Company and Jack E. Jerrett is 
incorporated by reference to Exhibit 99.3 to the Company’s current Report on Form 8-K filed March 31, 2015.* 

Retirement  Agreement,  dated  as  of  May  1,  2020,  between  OraSure  technologies,  Inc.  and  Anthony  Zezzo  II  is 
incorporated by reference to Exhibit 10.1 to the Company’s Current Report on For 8-K filed May 5, 2020* 

Employment  Agreement,  dated  as  of  January  1,  2019,  between  Kathleen  G.  Weber,  DNA  Genotek,  Inc.  and  OraSure 
Technologies, Inc. is incorporated by reference to Exhibit 10.21 to the Company’s Annual Report on Form 10-K for the 
year ended December 31, 2018.*

Employment Agreement, dated as of May 11, 2020, between OraSure Technologies, Inc. and Lisa Nibauer is incorporated 
by reference to Exhibit 10.2 to the Company’s Quarterly Report on form 10-Q for the quarter ended June 30, 2020.* 

10.10 Description of Non-Employee Director Compensation Policy, as amended, is incorporated by reference to Item 5.02 to the 

Company’s Current Report on form 8-K filed August 14, 2019.*

10.11 Amended  and  Restated  Epitope,  Inc.  1991  Stock  Award  Plan  is  incorporated  by  reference  to  Exhibit  10.9  to  the 

Company’s Annual Report on Form 10-K for the year ended December 31, 2002.* 

10.12 OraSure Technologies, Inc. Employee Incentive and Non-Qualified Stock Option Plan, as amended and restated effective 
September 29, 2000, is incorporated by reference to Exhibit 10.12 to the Company’s Annual Report on Form 10-K for the 
year ended December 31, 2000.* 

65

 
Exhibit
Number 
10.13 Amended  and  Restated  OraSure  Technologies,  Inc.  Stock  Award  Plan,  effective  April  4,  2020,  is  incorporated  by 
reference  to  Exhibit  A  to  the  Company’s  Proxy  Statement,  filed  April 9,  2020,  for  the  2020  Annual  Meeting  of 
Stockholders.* 

Exhibit 

10.14

10.15

10.16

Form of Restricted Share Award Agreement (Executive Officers – Employment Agreements) is incorporated by reference 
to Exhibit 10.24 to the Company’s Annual Report on Form 10-K for the year ended December 31, 2015.* 

Form of Restricted Unit Award Agreement (Executive Officers – Employment Agreements) is incorporated by reference 
to Exhibit 10.27 to the Company’s Annual Report on Form 10-K for the year ended December 31, 2016. * 

Form of Restricted Share Grant Agreement (Non-Employee Directors) is incorporated by reference to Exhibit 10.24 to the 
Company’s Annual Report on Form 10-K for the year ended December 31, 2011.* 

10.17 Nonqualified  Stock  Option  Award  General  Terms  and  Conditions  (Executive  Officers)  is  incorporated  by  reference  to 

Exhibit 10.25 to the Company’s Annual Report on Form 10-K for the year ended December 31, 2011.* 

10.18 Nonqualified Stock Option Award General Terms and Conditions (Non-Employee Directors) is incorporated by reference 

to Exhibit 10.26 to the Company’s Annual Report on Form 10-K for the year ended December 31, 2011.* 

10.19 Description  of  the  OraSure  Technologies,  Inc.  2020  Incentive  Plan  is  incorporated  by  reference  to  Item  5.02  to  the 

Company’s Current Report on Form 8-K filed February 21, 2020.* 

10.20 Description of Long-Term Incentive Policy and 2019 Award Performance Measures is incorporated by reference to Item 

5.02 to the Company’s Current Report on Form 8-K filed February 21, 2020.*

10.21

10.22

OraSure Technologies, Inc. Deferred Compensation Plan is incorporated by reference to Exhibit 99.1 to the Company’s 
Current Report on Form 8-K filed December 21, 2011.* 

Adoption Agreement related to OraSure Technologies, Inc. Deferred Compensation Plan is incorporated by reference to 
Exhibit 99.2 to the Company’s Current Report on Form 8-K filed December 21, 2011.* 

10.23 Amended and Restated Code of Business Conduct and Ethics of OraSure Technologies, Inc. is incorporated by reference 

to Exhibit 14.1 to the Company’s Current Report on Form 8-K filed August 14, 2019.

21

23

24

31.1

31.2

32.1

32.2

Subsidiaries of the Company are incorporated by reference to Exhibit 21 to the Company’s Annual Report on Form 10-K 
for the year ended December 31, 2013. 

Consent of KPMG LLP. 

Powers of Attorney.

Certification of Stephen S. Tang, Ph.D. required by Rule 13a-14(a) or Rule 15d-14(a) under the Securities Exchange Act 
of 1934, as amended. 

Certification of Roberto Cuca required by Rule 13a-14(a) or Rule 15d-14(a) under the Securities Exchange Act of 1934, 
as amended. 

Certification of Stephen S. Tang, Ph.D. required by Rule 13a-14(b) or Rule 15a-14(b) under the Securities Exchange Act 
of  1934,  as  amended,  and  18  U.S.C.  Section 1350,  as  Adopted  Pursuant  to  Section 906  of  the  Sarbanes-Oxley  Act  of 
2002. 

Certification of Roberto Cuca required by Rule 13a-14(b) or Rule 15a-14(b) under the Securities Exchange Act of 1934, 
as amended, and 18 U.S.C. Section 1350, as Adopted Pursuant to Section 906 of the Sarbanes-Oxley Act of 2002. 

101.INS

Inline XBRL Instance Document 

101.SCH Inline XBRL Taxonomy Extension Schema Document 

101.CAL Inline XBRL Taxonomy Extension Calculation Linkbase Document 

101.DEF

Inline XBRL Taxonomy Extension Definition Linkbase Document 

101.LAB Inline XBRL Taxonomy Extension Label Linkbase Document 

101.PRE

Inline XBRL Taxonomy Extension Presentation Linkbase document 

66

104

The  cover  page  from  the  Company’s  Annual  Report  on  Form  10-K  for  the  year  ended  December  31,  2020,  has  been 
formatted in Inline XBRL.

*

Management contract or compensatory plan or arrangement. 

ITEM 16.

Form 10-K Summary. 

None 

67

 
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, on March 1, 2021. 

SIGNATURES 

ORASURE TECHNOLOGIES, INC.

By:

/s/ Stephen S. Tang
Stephen S. Tang, Ph.D.
President and Chief Executive Officer

Pursuant to the requirements of the Securities Exchange Act of 1934, this report has been signed on March 1, 2021, by the following 
persons on behalf of the Registrant and in the capacities indicated. 

SIGNATURE

TITLE

/s/ Stephen S. Tang
Stephen S. Tang, Ph.D.

/s/ Roberto Cuca
Roberto Cuca

/s/ Michele Miller
Michele Miller

*MARA ASPINALL
Mara Aspinall

*MICHAEL CELANO
Michael Celano

*JAMES A. DATIN
James A. Datin

*EAMONN P. HOBBS
Eamonn P. Hobbs

*RONNY B. LANCASTER
Ronny B. Lancaster

*LELIO MARMORA
Lelio Marmora

*DAVID J. SHULKIN, M.D.
David J. Shulkin, M.D.

*By:

/s/ Jack E. Jerrett
Jack E. Jerrett
(Attorney-in-Fact)

President, Chief Executive Officer and Director
 (Principal Executive Officer)

Chief Financial Officer 
(Principal Financial Officer)

Vice President, Finance and Controller 
(Principal Accounting Officer)

Director

Director

Director

Director

Director

Director

Director

68

Index to Consolidated Financial Statements

Report of Independent Registered Public Accounting Firm..........................................................................................................

Consolidated Balance Sheets  ........................................................................................................................................................

Consolidated Statements of Operations .........................................................................................................................................

Consolidated Statements of Comprehensive Income (Loss)  ........................................................................................................

Consolidated Statements of Stockholders’ Equity ........................................................................................................................

Consolidated Statements of Cash Flows........................................................................................................................................

Notes to the Consolidated Financial Statements ...........................................................................................................................

Page

F-2

F-4

F-5

F-6

F-7

F-8

F-9

 
 
 
REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM 

To the Stockholders and Board of Directors
OraSure Technologies, Inc.:

Opinion on the Consolidated Financial Statements

We have audited the accompanying consolidated balance sheets of OraSure Technologies, Inc. and subsidiaries (the Company) as of 
December 31, 2020  and  2019,  the  related  consolidated  statements  of  operations,  comprehensive  income  (loss),  stockholders’  equity 
and  cash  flows  for  each  of  the  years  in  the  three-year  period  ended  December 31, 2020,  and  the  related  notes  (collectively,  the 
consolidated  financial  statements). In  our  opinion,  the  consolidated  financial  statements  present  fairly,  in  all  material  respects,  the 
financial position of the Company as of December 31, 2020 and 2019, and the results of its operations and its cash flows for each of 
the years in the three-year period ended December 31, 2020, in conformity with U.S. generally accepted accounting principles.

We  also  have  audited,  in  accordance  with  the  standards  of  the  Public  Company  Accounting  Oversight  Board  (United  States) 
(PCAOB), the Company’s internal control over financial reporting as of December 31, 2020, based on criteria established in Internal 
Control – Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission, and our 
report  dated  March 1, 2021  expressed  an  unqualified  opinion  on  the  effectiveness  of  the  Company’s  internal  control  over  financial 
reporting.

Change in Accounting Principle

As  discussed  in  Note 9  to  the  consolidated  financial  statements,  the  Company  has  elected  to  change  its  method  of  accounting 
for leases as of January 1, 2019 due to the adoption of Accounting Standards Update No. 2016-02, Leases.

Basis for Opinion

These  consolidated  financial  statements  are  the  responsibility  of  the  Company’s  management.  Our  responsibility  is  to  express  an 
opinion on these consolidated financial statements based on our audits. We are a public accounting firm registered with the 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 audit 
to obtain reasonable assurance about whether the consolidated financial statements are free of material misstatement, whether due to 
error or fraud. Our audits 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. We believe that our audits provide a reasonable basis for our opinion.

Critical Audit Matter

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: (1) relates to accounts or disclosures that are 
material to the consolidated financial statements and (2) involved our especially challenging, subjective, or complex judgments. The 
communication of a critical audit matter 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.

Evaluation of net realizable value adjustments to inventories for excess or obsolescence

As  discussed  in  Notes  2  and  5  to  the  consolidated  financial  statements,  the  Company  has  inventories  with  a  carrying  value  of 
$31,863  thousand  as  of  December  31,  2020.  Inventories  are  stated  at  the  lower  of  cost  or  net  realizable  value,  with  cost 
determined on a first-in, first-out basis. The majority of the inventories are subject to expiration dating, which can be extended in 
certain circumstances. The Company continually evaluates quantities on hand and the carrying value of inventories to determine 
the need for net realizable value adjustments for excess and obsolete inventories, based on prior experience as well as estimated 
forecasts  of  product  sales.  The  Company  reserves  for  unidentified  scrap  or  spoilage  based  on  historical  write-off  rates.    The 
Company also considers items identified through specific identification procedures in assessing the adequacy of the reserve.

F-2

We  identified  the  evaluation  of  net  realizable  value  adjustments  to  inventories  for  excess  or  obsolescence  as  a  critical  audit 
matter.  Evaluating  the  Company’s  specific  identification  procedures,  which  included  estimates  of  forecasted  sales  and  the 
resulting inventory consumption and ability to extend inventory expiration dates, required a high degree of auditor judgment.

The following are the primary procedures we performed to address this critical audit matter. We evaluated the design and tested 
the  operating  effectiveness  of  certain  internal  controls  related  to  the  Company’s  process  for  determining  net  realizable  value 
adjustments  for  inventory  excess  or  obsolescence,  which  included  controls  related  to  the  review  of  the  specific  identification 
procedures. For a selection of inventory items, we compared the Company’s historic estimates of net realizable value adjustments 
for excess and obsolescence to the actual physical inventory disposals to evaluate the Company’s ability to accurately estimate the 
net realizable value adjustments.  We evaluated the Company’s ability to forecast sales by comparing prior period sales forecasts 
to actual results.  In addition, we selected inventory items from the underlying data used in the Company’s analysis and evaluated 
the Company’s determination of net realizable value adjustments for those items by comparing forecasted inventory consumption 
to historic inventory consumption. We also selected inventory items from the underlying data used in the Company’s analysis and 
evaluated the ability to extend the expiration dates by inspecting relevant supporting documentation.

/s/ KPMG LLP

We have served as the Company’s auditor since 2002.

Philadelphia, Pennsylvania
March 1, 2021

F-3

 
ORASURE TECHNOLOGIES, INC. AND SUBSIDIARIES 
CONSOLIDATED BALANCE SHEETS 
(in thousands, except per share amounts) 

December 31, 2020

December 31, 2019

ASSETS
Current Assets:

Cash and cash equivalents.........................................................................................   $
Short-term investments .............................................................................................  
Accounts receivable, net of allowance for doubtful accounts of $3,654
   and $2,666 ..............................................................................................................  
Inventories.................................................................................................................  
Prepaid expenses .......................................................................................................  
Other current assets ...................................................................................................  
Total current assets ..............................................................................................  

Noncurrent Assets:

Property, plant and equipment, net............................................................................  
Operating right-of-use assets, net..............................................................................  
Finance right-of-use assets, net .................................................................................  
Intangible assets, net .................................................................................................  
Goodwill....................................................................................................................  
Long-term investments..............................................................................................  
Other noncurrent assets .............................................................................................  
Total noncurrent assets ........................................................................................  

TOTAL ASSETS ..........................................................................................................   $
LIABILITIES AND STOCKHOLDERS' EQUITY
Current Liabilities:

Accounts payable ......................................................................................................   $
Deferred revenue .......................................................................................................  
Accrued expenses......................................................................................................  
Finance lease liability................................................................................................  
Operating lease liability ............................................................................................  
Acquisition-related contingent consideration obligation ..........................................  
Total current liabilities.........................................................................................  

Noncurrent Liabilities:

 Finance lease liability...............................................................................................  
 Operating lease liability ...........................................................................................  
 Acquisition-related contingent consideration obligation .........................................  
 Other noncurrent liabilities ......................................................................................  
 Deferred income taxes..............................................................................................  
                 Total noncurrent liabilities.............................................................................  
TOTAL LIABILITIES.................................................................................................  
COMMITMENTS AND CONTINGENCIES (Note 14)
STOCKHOLDERS' EQUITY

Preferred stock, par value $.000001, 25,000 shares authorized, none issued ...........  
Common stock, par value $.000001, 120,000 shares authorized, 71,738 and
   61,731 shares issued and outstanding ....................................................................  
Additional paid-in capital..........................................................................................  
Accumulated other comprehensive loss....................................................................  
Accumulated deficit ..................................................................................................  
Total stockholders' equity ....................................................................................  

TOTAL LIABILITIES AND STOCKHOLDERS' EQUITY ..................................   $

160,802 
48,599 

  $

  $

  $

38,835 
31,863 
3,860 
4,934 
288,893 

51,860 
4,461 
1,312 
17,904 
40,351 
47,718 
1,973 
165,579 
454,472 

17,407 
4,811 
22,227 
517 
1,125 
402 
46,489 

895 
3,591 
2,049 
1,682 
1,195 
9,412 
55,901 

— 

— 
505,123 

(9,097)    
(97,455)    
398,571 
454,472 

  $

75,715 
80,623 

36,948 
23,155 
2,433 
5,676 
224,550 

30,339 
4,996 
1,951 
14,674 
36,201 
33,420 
3,164 
124,745 
349,295 

9,567 
3,713 
14,288 
613 
1,032 
3,500 
32,713 

1,372 
4,206 
112 
2,848 
899 
9,437 
42,150 

— 

— 
401,814 
(12,136)
(82,533)
307,145 
349,295  

See accompanying notes to the consolidated financial statements. 

F-4

 
 
 
 
 
 
   
 
     
 
 
   
 
     
 
 
   
 
   
 
   
 
   
 
   
 
   
 
   
 
     
 
 
   
 
   
 
   
 
   
 
   
 
   
 
   
 
   
 
   
 
     
 
 
   
 
     
 
 
   
 
   
 
   
 
   
 
   
 
   
 
   
 
     
 
 
   
 
   
 
   
 
   
 
   
 
   
 
   
 
   
 
     
 
 
   
 
     
 
 
   
 
   
 
   
 
 
 
   
 
ORASURE TECHNOLOGIES, INC. AND SUBSIDIARIES 
CONSOLIDATED STATEMENTS OF OPERATIONS 
(in thousands, except per share amounts) 

For the years ended December 31,
2019

2018

2020

NET REVENUES:

Products and services ...................................................................................  $
Other .............................................................................................................   

COST OF PRODUCTS SOLD..........................................................................   
Gross profit...................................................................................................   

OPERATING EXPENSES:

Research and development ...........................................................................   
Sales and marketing......................................................................................   
General and administrative...........................................................................   
Change in the estimated fair value of acquisition-related contingent 
consideration ................................................................................................   
Gain on sale of business ...............................................................................   

Operating income (loss) ...............................................................................   
OTHER INCOME .............................................................................................   
Income (loss) before income taxes ...............................................................   
INCOME TAX EXPENSE ................................................................................   
NET INCOME (LOSS)......................................................................................  $
EARNINGS (LOSS) PER SHARE:

166,381    $
5,340     
171,721     
69,853     
101,868     

31,032     
34,459     
42,653     

(1,099)    

107,045     
(5,177)    
1,653     
(3,524)    
11,398     
(14,922)   $

148,073    $
6,532     
154,605     
60,022     
94,583     

19,629     
31,869     
35,287     

(664)    
(10,149)    
75,972     
18,611     
2,720     
21,331     
4,675     
16,656    $

BASIC ..........................................................................................................  $
DILUTED.....................................................................................................  $

(0.22)   $
(0.22)   $

0.27    $
0.27    $

SHARES USED IN COMPUTING EARNINGS (LOSS) PER SHARE:

BASIC ..........................................................................................................   
DILUTED.....................................................................................................   

67,505     
67,505     

61,675     
62,170     

165,428 
16,315 
181,743 
68,130 
113,613 

16,250 
30,609 
38,325 

— 
— 
85,184 
28,429 
3,287 
31,716 
11,320 
20,396 

0.33 
0.33 

61,112 
62,532  

See accompanying notes to the consolidated financial statements.

F-5

 
 
 
 
 
   
   
 
   
      
      
  
 
   
   
      
      
  
      
 
   
   
      
      
  
   
      
      
  
 
ORASURE TECHNOLOGIES, INC. AND SUBSIDIARIES 
CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) 
(in thousands) 

NET INCOME (LOSS)......................................................................................  $
OTHER COMPREHENSIVE INCOME (LOSS)

Currency translation adjustments .................................................................   
Unrealized gain (loss) on marketable securities...........................................   
COMPREHENSIVE INCOME (LOSS)............................................................  $

For the years ended December 31,
2019

2018

2020

(14,922)   $

16,656    $

20,396 

3,273     
(234)    
(11,883)   $

5,767     
803     
23,226    $

(8,003)
(363)
12,030  

See accompanying notes to the consolidated financial statements. 

F-6

 
 
 
 
 
 
 
 
 
 
   
      
      
  
 
ORASURE TECHNOLOGIES, INC. AND SUBSIDIARIES 
CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY 
For the years ended December 31, 2020, 2019 and 2018 
(in thousands) 

Balance at January 1, 2018 ....................   
Adoption of ASU 2014-9..........................   
Common stock issued upon exercise
   of options ...............................................   
Vesting of restricted stock ........................   
Purchase and retirement of common 
shares ........................................................   
Stock-based compensation........................   
Net income................................................   
Currency translation adjustments .............   
Unrealized loss on marketable
   securities ................................................   
Balance at December 31, 2018 ...............   
Common stock issued upon exercise
   of options ...............................................   
Vesting of restricted stock and 
performance stock units............................   
Purchase and retirement of common 
shares ........................................................   
Stock-based compensation........................   
Net income................................................   
Currency translation adjustments .............     
Unrealized gain on marketable
   securities ................................................   
Balance at December 31, 2019 ...............   
Common stock issued upon exercise
   of options ...............................................   
Vesting of restricted stock and 
performance stock units............................   
Purchase and retirement of common 
shares ........................................................   
Issuance of common stock in connection 
with public offering, net of commissions 
and expenses of $6,200.............................   
Stock-based compensation........................   
Net loss .....................................................   
Currency translation adjustments .............     
Unrealized loss on marketable
   securities ................................................   
Balance at December 31, 2020 ...............   

Common Stock

Shares

Amount

60,662     

—     

Additional
Paid-in
Capital

387,931     

Accumulated
Other
Comprehensive 
Loss
(10,340)    

  Accumulated  
Deficit
(119,510)    
(75)    

Total
258,081 
(75)

227     
578     

(191)    
—     
—     
—     

—     
61,276     

—     
—     

—     
—     
—     
—     

—     
—     

1,697     
—     

(3,592)    
15,237     
—     
—     

—     
—     

—     
—     

1,697 
— 

—     
—     
—     
(8,003)    

—     
—     
20,396     
—     

(3,592)
15,237 
20,396 
(8,003)

—     
401,273     

(363)    
(18,706)    

—     
(99,189)    

(363)
283,378 

27     

—     

196     

717     

(289)    
—     
—     

—     

—     
—     
—     

—     

(3,712)    
4,057     
—     

—     

—     

—     
—     
—     
5,767       

—     

—     

—     
—     
16,656     

196 

— 

(3,712)
4,057 
16,656 
5,767 

—     
61,731     

—     
—     

—     
401,814     

803     
(12,136)    

—     
(82,533)    

803 
307,145 

402     

—     

3,222     

653     

—     

—     

(248)    

—     

(2,088)    

—     

—     

—     

—     

3,222 

—     

— 

—     

(2,088)

9,200       
—     
—     

—     
—     

95,036       
7,139     
—     

—     
—     
3,273       

—     
(14,922)    

95,036 
7,139 
(14,922)
3,273 

—     
71,738    $

—     
—    $

—     
505,123    $

(234)    
(9,097)   $

—     
(97,455)   $

(234)
398,571  

See accompanying notes to the consolidated financial statements.

F-7

 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
        
       
       
     
       
       
     
     
     
       
     
       
       
     
     
ORASURE TECHNOLOGIES, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF CASH FLOWS
(in thousands)

OPERATING ACTIVITIES:
Net income (loss) ...............................................................................................  $

Adjustments to reconcile net income (loss) to net cash provided by
   operating activities:

Stock-based compensation......................................................................   
Depreciation and amortization ................................................................   
Other non-cash amortization...................................................................   
Provision for doubtful accounts ..............................................................   
Unrealized foreign currency (gain) loss..................................................   
Interest expense on finance leases ..........................................................   
Deferred income taxes ............................................................................   
Loss on sale of fixed assets .....................................................................   
Gain on sale of product line ....................................................................   
Gain on sale of business..........................................................................   
Change in the estimated fair value of contingent earn-out 
consideration ...........................................................................................   
Payment of acquisition related contingent consideration .......................   
Changes in assets and liabilities

Accounts receivable...........................................................................   
Inventories .........................................................................................   
Prepaid expenses and other assets .....................................................   
Accounts payable...............................................................................   
Deferred revenue ...............................................................................   
Accrued expenses and other liabilities ..............................................   
Net cash provided by operating activities ....................................   

INVESTING ACTIVITIES:

Purchases of investments ........................................................................   
Proceeds from maturities and redemptions of investments ....................   
Purchases of property and equipment .....................................................   
Purchase of patent and product rights .....................................................   
Acquisition of businesses, net of cash acquired......................................   
Proceeds from sale of business ...............................................................   
Other investing activities ........................................................................   
Net cash used in investing activities ............................................   

FINANCING ACTIVITIES:

Repayments of loans ...............................................................................   
Cash payments for lease liability ............................................................   
Proceeds from issuance of common stock, net .......................................   
Proceeds from exercise of stock options.................................................   
Payment of acquisition related contingent consideration .......................   
Repurchase of common stock .................................................................   
Net cash provided by (used in) financing activities.....................   
EFFECT OF FOREIGN EXCHANGE RATE CHANGES ON CASH............   
NET INCREASE (DECREASE) IN CASH AND CASH EQUIVALENTS....   
CASH AND CASH EQUIVALENTS, BEGINNING OF PERIOD .................   
CASH AND CASH EQUIVALENTS, END OF PERIOD ...............................  $

For the years ended December 31,
2019

2018

2020

(14,922)   $

16,656    $

20,396 

7,139     
9,387     
327     
941     
269     
72     
(392)    
114     
(225)    
—     

(1,099)    
(496)    

(2,324)    
(8,607)    
(104)    
7,379     
1,051     
7,297     
5,807     

(90,137)    
107,718     
(26,674)    
(2,250)    
(3,037)    
—     
351     
(14,029)    

—     
(687)    
95,036     
3,222     
(3,004)    
(2,088)    
92,479     
830     
85,087     
75,715     
160,802    $

4,057     
7,339   
391   
2,248   
385   
36   
(1,457)  
147   
— 
(10,149)

(664)    
—   

(2,210)    
(1,324)    
200   
(1,537)    
(297)    

(4,017)  
9,804   

(92,173)  
93,491   
(9,314)  
—   
(23,801)  
12,000   
—   
(19,797)  

(724)  
(442)  
—   
196   
—   
(3,712)  
(4,682)  
1,952   
(12,723)  
88,438   
75,715    $

15,237 
6,451 
771 
(53)
(400)
— 
(919)
— 
— 
— 

— 
— 

6,688 
(3,857)
(366)
208 
2,240 
(7,306)
39,090 

(163,763)
152,680 
(6,344)
— 
— 
— 
— 
(17,427)

— 
— 
— 
1,701 
— 
(3,592)
(1,891)
(4,203)
15,569 
72,869 
88,438  

See accompanying notes to the consolidated financial statements. 

F-8

 
 
 
 
 
 
   
   
 
     
       
   
   
 
     
       
   
   
 
 
 
 
 
 
 
 
  
  
 
     
       
   
 
  
 
 
 
     
       
   
   
 
 
 
 
 
 
 
 
 
     
       
       
 
 
 
 
 
 
 
 
 
 
 
 
ORASURE TECHNOLOGIES, INC. AND SUBSIDIARIES 

NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS 

(in thousands, except per share amounts, unless otherwise indicated) 

1.

THE COMPANY: 

The overall goal of OraSure Technologies, Inc. (“OraSure” or “the Company”) is to empower the global community to improve health 
and  wellness  by  providing  access  to  accurate  essential  information.  Our  business  consists  of  two  segments:  our  “Diagnostics” 
segment, which was previously named “OSUR” and our “Molecular Solutions” segment, which was previously name “DNAG”. Our 
Diagnostics  business  primarily  consists  of  the  development,  manufacture,  marketing  and  sale  of  oral  fluid  diagnostic  products  and 
specimen  collection  devices  using  our  proprietary  technologies,  as  well  as  other  diagnostic  products  including  immunoassays  and 
other in vitro diagnostic tests that are used on other specimen types. Our Molecular Solutions business consists of the manufacture and 
sale of kits that are used to collect, stabilize, transport and store biological samples of genetic material for molecular testing  in the 
consumer  genetic,  clinical  genetic,  academic  research,  infectious  disease  diagnostics,  pharmacogenomics,  personalized  medicine, 
microbiome and animal genetics markets. Our collection kits are also used for the collection of first-void urine for liquid biopsy in the 
prostate and bladder cancer markets and in the sexually transmitted infection screening market. In addition, our Molecular Solutions 
business provides microbiome laboratory and bioinformatics services. 

The Diagnostics business includes tests for diseases including HIV and Hepatitis C that are performed on a rapid basis at the point of 
care and tests that are processed in a laboratory. These products are sold in the United States and internationally to various clinical 
laboratories,  hospitals,  clinics,  community-based  organizations,  and  other  public  health  organizations,  distributors,  government 
agencies, physicians’ offices, and commercial and industrial entities. Our HIV product is also sold in a consumer-friendly format in 
the  over-the-counter  (“OTC”)  market  in  the  U.S.  and  as  a  self-test  to  individuals  in  a  number  of  other  countries.  Our  Diagnostics 
business includes the operations of UrSure, Inc. (“UrSure”), which was acquired and merged into OraSure in 2020. This part of the 
business  develops  and  commercializes  products  that  measure  adherence  to  HIV  medications  including  pre-exposure 
prophylaxis or PrEP, the daily medication to prevent HIV. These products include laboratory-based tests that can measure 
levels of the medication in a patient’s urine or blood, as well as point of care products currently in development. We also 
previously manufactured and sold medical devices used for the removal of benign skin lesions by cryosurgery or freezing. We sold the 
assets associated with our cryosurgical systems business to a third party in August 2019. In 2020, we began the development of a rapid 
antigen self-test for COVID-19 and a COVID-19 antibody ELISA test for use in laboratory settings.  We expect to begin selling these 
products in 2022.

Our Molecular Solutions business is operated by our subsidiaries, DNA Genotek Inc. (“DNAG”), Diversigen, Inc. (“Diversigen”), and 
Novosanis NV (“Novosanis”). In DNAG’s business, we manufacture and sell kits that are used to collect, stabilize, transport and store 
biological sample of genetic material for molecular testing.  Our products are used for academic research and commercial applications, 
including  ancestry,  disease  risk  management,  lifestyle  and  animal  testing.    In  2020,  two  of  our  collection  devices  were  used  in 
connection with COVID-19 molecular testing.  We also sell research use only collection products into the microbiome market. We 
offer  our  customers  a  suite  of  genomics  and  microbiome  services  that  range  from  package  customization  and  study  design 
optimization  to  extraction,  analysis  and  reporting  services.  The  microbiome  laboratory  and  bioinformatics  services  are  provided  by 
Diversigen, which includes the operations of CoreBiome, Inc. (“CoreBiome”), a subsidiary we acquired in early 2019.  CoreBiome 
and Diversigen were merged together in 2020.  Novosanis manufactures and sells the Colli-Pee® collection device for the volumetric 
collection  of  first-void  urine  for  use  in  research,  screening  and  diagnostics  in  the  liquid  biopsy  and  sexually  transmitted  infection 
markets.    Our  Molecular  Solutions  business  serves  customers  in  many  countries  worldwide,  including  many  leading  research 
universities and hospitals.

F-9

   
 
2.

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES:

Principles of Consolidation and Basis of Presentation

The  consolidated  financial  statements  include  the  accounts  of  OraSure  Technologies,  Inc.  (“OraSure”)  and  its  wholly-owned 
subsidiaries, DNAG, Diversigen, and Novosanis. All intercompany transactions and balances have been eliminated. References herein 
to “we,” “us,” “our,” or the “Company” mean OraSure and its consolidated subsidiaries, unless otherwise indicated.

Use of Estimates 

The preparation of consolidated financial statements in conformity with accounting principles generally accepted in the United States 
of America requires management to make estimates and assumptions about future events. These estimates and underlying assumptions 
affect  the  amounts  of  assets  and  liabilities  reported,  disclosures  about  contingent  assets  and  liabilities,  and  reported  amounts  of 
revenues and expenses. Such estimates include the fair value of assets acquired and liabilities assumed for business combinations, the 
valuation of accounts receivable and inventories and assumptions utilized in impairment testing for intangible assets and goodwill, as 
well as calculations related to accruals, taxes, contingent consideration and performance-based compensation expense, among others. 
These estimates and assumptions are based on management’s best estimates and judgment. Management evaluates its estimates and 
assumptions on an ongoing basis, using historical experience and other factors, which management believes to be reasonable under the 
circumstances, including the current economic environment. As future events and their effects cannot be determined with precision, 
actual  results  could  differ  significantly  from  these  estimates.  Changes  in  those  estimates  resulting  from  continuing  changes  in  the 
economic environment and other factors will be reflected in the financial statements in those future periods.

Supplemental Cash Flow Information 

In 2020, 2019 and 2018, we paid income taxes of $9,263, $10,611 and $17,126, respectively.

In 2020, 2019 and 2018, we recorded through the consolidated statements of operations an increase (decrease) in our allowance for 
doubtful  accounts  of  $941,  $2,248  and  $(53),  respectively.  We  had  write-offs  of  $501,  $110  and  $11  in  2020,  2019,  and  2018, 
respectively.  

As  of  December 31,  2020,  2019  and  2018,  we  had  accruals  for  purchases  of  property  and  equipment  of  $802,  $660,  and  $964, 
respectively. 

Investments 

We  consider  all  investments  in  debt  securities  to  be  available-for-sale  securities.  These  securities  are  comprised  of  guaranteed 
investment  certificates  and  corporate  bonds  with  purchased  maturities  greater  than  ninety  days.  Available-for-sale  securities  are 
carried at fair value, based upon quoted market prices, with unrealized gains and losses, if any, reported in stockholders’ equity as a 
component of accumulated other comprehensive loss.

We record an allowance for credit loss for our available-for-sale securities when a decline in investment market value is due to credit-
related factors. When evaluating an investment for impairment, we review factors such as the severity of the impairment, changes in 
underlying  credit  ratings,  forecasted  recovery,  the  Company’s  intent  to  sell  or  the  likelihood  that  it  would  be  required  to  sell  the 
investment before its anticipated recovery in market value and the probability that the scheduled cash payments will continue to be 
made. As of December 31, 2020, we determined that the decline in the market value of our available-for-sale investment was not due 
to credit-related factors and as such no allowance for credit-loss was necessary.

The following is a summary of our available-for-sale securities as of December 31, 2020 and 2019:

F-10

Amortized
Cost

Gross
Unrealized
Gains

Gross
Unrealized
Losses

December 31, 2020

Guaranteed investment certificates ....................................  $25,132
Corporate bonds .................................................................    71,533
Total available-for-sale securities............................................  $96,665
December 31, 2019

Guaranteed investment certificates ....................................  $24,632
Corporate bonds .................................................................    89,525
Total available-for-sale securities............................................  $114,157
At December 31, 2020, maturities of our available-
   for-sale securities were as follows:

    $—
      135
    $135

    $—
      271
    $271

    $—
      (483
    $(483

    $—
      (385
    $(385

    Fair Value

    $25,132
)     71,185
)   $96,317

    $24,632
)     89,411
)   $114,043

Less than one year..............................................................  $48,835
Greater than one year .........................................................  $47,830

    $114
    $21

    $(350
    $(133

)   $48,599
)   $47,718

Fair Value of Financial Instruments 

As  of  December 31,  2020  and  2019,  the  carrying  values  of  cash  and  cash  equivalents,  accounts  receivable,  accounts  payable,  and 
accrued expenses approximate their respective fair values based on their short-term nature. 

Fair value measurements of all financial assets and liabilities that are being measured and reported on a fair value basis are required to 
be classified and disclosed in one of the following three categories: 

Level 1:  Unadjusted quoted prices in active markets that are accessible at the measurement date for identical, unrestricted assets 
or liabilities;

Level 2:    Quoted  prices  in  markets  that  are  not  active,  or  inputs  which  are  observable,  either  directly  or  indirectly,  for 
substantially the full term of the asset or liability; and

Level 3:    Prices  or  valuation  techniques  that  require  inputs  that  are  both  significant  to  the  fair  value  measurement  and 
unobservable (i.e., supported by little or no market activity).

All of our available-for-sale debt securities are measured as Level 2 instruments as of December 31, 2020 and 2019. Our guaranteed 
investment certificates are measured as Level 1 instruments as of December 31, 2020 and 2019.

Included in cash and cash equivalents at December 31, 2020 and 2019, was $71,489 and $1,624 invested in government money market 
funds. These funds have investments in government securities and are measured as Level 1 instruments.

F-11

 
 
   
   
 
     
       
       
       
 
 
 
 
     
       
       
       
 
 
 
 
     
       
       
       
 
 
 
We offer a nonqualified deferred compensation plan for certain eligible employees and members of our Board of Directors. The assets 
of  the  plan  are  held  in  the  name  of  the  Company  at  a  third-party  financial  institution.  Separate  accounts  are  maintained  for  each 
participant to reflect the amounts deferred by the participant and all earnings and losses on those deferred amounts. The assets of the 
plan  are  held  in  mutual  funds.  The  fair  value  of  the  plan  assets  as  of  December 31,  2020  and  2019  was  $2,565  and  $3,519, 
respectively,  and  was  calculated  using  the  quoted  market  prices  of  the  assets  as  of  those  dates.  All  investments  in  the  plan  are 
classified as trading securities and measured as Level 1 instruments. The fair value of plan assets is included in both current assets and 
other  noncurrent  assets  with  the  same  amounts  included  in  accrued  expenses  and  other  noncurrent  liabilities  in  the  accompanying 
consolidated balance sheets.

As  further  discussed  in  Note  3,  Business  Combinations,  we  have  identified  our  contingent  consideration  obligations  as  Level  3 
liabilities due to significant inputs that are required to measure the fair value of these obligations. 

The following table represents the change in contingent consideration:

Balance as of January 1, 2019 ........................................................................  $—

Addition related to acquisition (initial measurement)...............................    4,350
Change in fair value during the period......................................................    (664
Currency translation adjustment ...............................................................    (74

Balance as of December 31, 2019 ..................................................................  

  3,612
Addition related to acquisition (initial measurement)...............................    3,440
Payments made during the period .............................................................    (3,500
Change in fair value during the period......................................................    (1,099
Currency translation adjustment ...............................................................    (2
Balance as of December 31, 2020 ..................................................................  $2,451

)
)

)
)
)

Accounts Receivable 

Accounts  receivable  have  been  reduced  by  an  estimated  allowance  for  amounts  that  may  become  uncollectible  in  the  future.  This 
estimated  allowance  is  based  primarily  on  management’s  evaluation  of  specific  balances  as  they  become  past  due,  the  financial 
condition of our customers and our historical experience related to write-offs.

Inventories 

Inventories are stated at the lower of cost or net realizable value, with cost determined on a first-in, first-out basis, and include the cost 
of raw materials, labor and overhead. The majority of our inventories are subject to expiration dating, which can be extended in certain 
circumstances. We continually evaluate quantities on hand and the carrying value of our inventories to determine the need for reserves 
for  excess  and  obsolete  inventories,  based  on  prior  experience  as  well  as  estimated  forecasts  of  product  sales.  We  reserve  for 
unidentified  scrap  or  spoilage  based  on  historical  write-off  rates.    We  also  consider  items  identified  through  specific  identification 
procedures  in  assessing  the  adequacy  of  our  reserve.    When  factors  indicate  that  impairment  has  occurred,  either  a  reserve  is 
established against the inventories’ carrying value or the inventories are completely written off, as in the case of lapsing expiration 
dates.  

Property, Plant and Equipment 

Property,  plant  and  equipment  are  stated  at  cost.  Additions  or  improvements  are  capitalized,  while  repairs  and  maintenance  are 
charged to expense. Depreciation and amortization are provided using the straight-line method over the estimated useful lives of the 
related  assets.  Buildings  are  depreciated  over  twenty  to  forty  years,  while  computer  equipment,  machinery  and  equipment,  and 
furniture and fixtures are depreciated over two to ten years. Building improvements are amortized over their estimated useful lives. 
When  assets  are  sold,  retired,  or  discarded,  the  related  property  amounts  are  relieved  from  the  accounts,  and  any  gain  or  loss  is 
recorded in the consolidated statements of operations. 

Intangible Assets 

Intangible  assets  consist  of  customer  relationships,  patents  and  product  rights,  acquired  technology  and  tradenames.  Patents  and 
product rights consist of costs associated with the acquisition of patents, licenses and product distribution rights. Intangible assets are 
amortized using the straight-line method over their estimated useful lives of five to fifteen years. 

F-12

 
 
 
 
 
Impairment of Long-Lived Assets 

Long-lived assets, which include property and equipment and definite-lived intangible assets, are tested for recoverability whenever 
events or changes in business circumstances indicate that the carrying amount of the assets may not be fully recoverable. We assess 
the recoverability of our long-lived assets by determining whether the carrying value of such assets can be recovered through the sum 
of the undiscounted future cash flows generated from the use and eventual disposition of the asset. If indicators of impairment exist, 
we measure the amount of such impairment by comparing the carrying value of the assets to the fair value of these assets, which is 
generally  determined  based  on  the  present  value  of  the  expected  future  cash  flows  associated  with  the  use  of  the  assets.  Expected 
future cash flows reflect our assumptions about selling prices, volumes, costs and market conditions over a reasonable period of time.

Goodwill 

Goodwill  represents  the  excess  of  the  purchase  price  over  the  fair  value  of  the  net  tangible  and  identifiable  intangible  assets 
acquired. Goodwill is not amortized but rather is tested annually for impairment or more frequently if we believe that indicators of 
impairment exist. Current generally accepted accounting principles permit us to make a qualitative evaluation about the likelihood of 
goodwill impairment. If we conclude that it is more likely than not that the carrying value of a reporting unit is greater than its fair 
value,  then  we  would  be  required  to  recognize  an  impairment  charge  for  the  amount  by  which  the  carrying  amount  exceeds  the 
reporting  unit’s  fair  value,  provided  the  impairment  charge  does  not  exceed  the  total  amount  of  goodwill  allocated  to  the  reporting 
unit. 

We performed our annual impairment assessment as of July 31, 2020 utilizing a qualitative evaluation and concluded that it was more 
likely  than  not  that  the  fair  value  of  our  reporting  units  is  greater  than  their  carrying  value.  We  believe  we  have  made  reasonable 
estimates  and  assumptions  to  calculate  the  fair  value  of  our  reporting  units.  If  actual  future  results  are  not  consistent  with 
management’s  estimates  and  assumptions,  we  may  have  to  take  an  impairment  charge  in  the  future  related  to  our  goodwill.  Future 
impairment tests will continue to be performed annually in the fiscal third quarter, or sooner if a triggering event occurs. 

Revenue

Product sales. Revenue from product sales is recognized upon transfer of control of a product to a customer based on an amount that 
reflects the consideration we are entitled to, net of allowances for any discounts or rebates.   

We generally do not grant product return rights to our customers, except for warranty returns, return rights on sales of our OraQuick® 
In-Home HIV test to the retail trade, and under the terms of a long-term contract with a genomics customer, which was amended in 
2020 to remove the return rights provision.  

Historically, returns arising from warranty issues have been infrequent and immaterial. Accordingly, we expense warranty returns as 
incurred. 

We record shipping and handling charges billed to our customers as product revenue and the related expense as cost of products sold.

Service  revenues.  Service  revenues  represent  microbiome  laboratory  testing  and  analytical  services.  We  recognize  revenues  and 
satisfy our performance obligation for services rendered. 

Arrangements  with  multiple-performance  obligations.    In  arrangements  involving  more  than  one  performance  obligation,  which 
largely applies to our service revenue stream, each required performance obligation is evaluated to determine whether it qualifies as a 
distinct performance obligation based on whether (i) the customer can benefit from the good or service either on its own or together 
with  other  resources  that  are  readily  available  and  (ii)  the  good  or  services  is  separately  identifiable  from  other  promises  in  the 
contract.  The consideration under the arrangement is then allocated to each separate distinct performance obligation based on their 
respective relative stand-alone selling price.  The estimated selling price of each deliverable is determined using an observable cost 
plus margin approach.  The consideration allocated to each distinct performance obligation is recognized as revenue when control is 
transferred for the related goods or services or when the performance obligation has been satisfied.    

Other  revenues.    Other  revenues  consist  primarily  of  royalty  income,  funding  of  research  and  development  efforts  and  cost 
reimbursements under a charitable support agreement.  Royalties from licensees are based on third-party sales of licensed products 
and are recorded when the related third-party product sale occurs.  Funding and charitable support reimbursements are recorded as the 
activities are being performed in accordance with the respective agreements.    

F-13

Deferred Revenue. We record deferred revenue when funds are received prior to the recognition of the associated revenue. Deferred 
revenue as of December 31, 2020 and 2019 included customer prepayments of $3,216 and $1,904, respectively. Deferred revenue as 
of December 31, 2020 and 2019 also included $1,595 and $1,809, respectively, associated with a long-term contract that has variable 
pricing  based  on  volume.  The  average  price  over  the  life  of  contract  was  determined  based  on  expected  revenues  and  revenue  is 
recognized at that rate when the product is delivered to the customer.     

Financing and Payment.  Our payment terms vary by the type and location of our customer and products or services offered.  Payment 
terms  differ  by  jurisdiction  and  customer  but  payment  is  generally  required  in  a  term  ranging  from  30  to  120  days  from  date  of 
shipment or satisfaction of the performance obligation.

For  certain  products  or  services  and  customer  types,  we  may  require  payment  before  the  products  are  delivered  or  services  are 
rendered to the customer.

Practical expedients and exemptions.  Taxes assessed by governmental authorities, such as sales or value-added taxes, are excluded 
from product revenues.

Sales commissions are expensed when incurred if the amortization period is one year or less.  These costs are recorded in sales and 
marketing expense in the consolidated statements of operations.  If the amortization period exceeds one year, we defer the cost of the 
commission and expense it over the life of the related sales contract.

Revenues by product.  The following table represents total net revenues by product line:

  Year Ended December 31,
  2020

Infectious disease testing................................................  $54,227
Risk assessment testing ..................................................    9,374
Cryosurgical systems......................................................    —
Genomics........................................................................    37,141
Microbiome ....................................................................    6,156
COVID-19......................................................................    49,802
Laboratory services ........................................................    9,564
Other product revenue ....................................................    117

    2019
   $58,016
     12,189
     7,054
     56,200
     7,172
     —
     6,767
     675

  2018
 $56,159
   12,058
   10,767
   79,754
   6,690
   —
   —
   —

Net product and service revenues .............................    166,381      148,073    165,428  

Royalty income ..............................................................    3,432
Other non-product revenues ...........................................    1,908
Other revenues ..........................................................    5,340
Net revenues .............................................................  $171,721    $154,605  $181,743  

     5,116
     1,416
     6,532

   9,653
   6,662
   16,315

Revenues  by  geographic  area.   The  following  table  represents  total  net  revenues  by  geographic  area,  based  on  the  location  of  the 
customer:

  Years Ended December 31,
  2020

    2019

    2018

United States ......................................................................   $130,835   $107,279   $136,847  
Europe ................................................................................     12,068      11,752      11,062
Other regions......................................................................     28,818      35,574      33,834

  $171,721   $154,605   $181,743  

Customer and Vendor Concentrations.  One of our customers accounted for 11% of our accounts receivable as of December 31, 2020 
and  another  customer  accounted  for  19%   of  our  accounts  receivable  as  of  December 31,  2019.  The  same  customer  accounted  for 
approximately 15% and 24% of our net consolidated revenues for the year ended December 31, 2019 and 2018, respectively. We had 
no customers that accounted for more than 10% of our consolidated net revenues for the year ended December 31, 2020.       

We currently purchase certain products and critical components of our products from sole-supply vendors. If these vendors are unable 
or  unwilling  to  supply  the  required  components  and  products,  we  could  be  subject  to  increased  costs  and  substantial  delays  in  the 

F-14

  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
delivery  of  our  products  to  our  customers.  Third-party  suppliers  also  manufacture  certain  products.  Our  inability  to  have  a  timely 
supply  of  any  of  these  components  and  products  could  have  a  material  adverse  effect  on  our  business,  as  well  as  our  financial 
condition and results of operations.  

Business Combinations and Contingent Consideration 

Acquired businesses are accounted for using the acquisition method of accounting, which requires that the purchase price be allocated 
to  the  net  assets  acquired  at  their  respective  fair  values.  Any  excess  of  the  purchase  price  over  the  estimated  fair  values  of the  net 
assets acquired is recorded as goodwill. Amounts allocated to contingent consideration are recorded to the balance sheet at the date of 
acquisition based on their relative fair values. The purchase price allocation requires us to make significant estimates and assumptions, 
especially at the acquisition date, with respect to intangible assets. Although we believe the assumptions and estimates we have made 
are  reasonable,  they  are  based  in  part  on  historical  experience  and  information  obtained  from  the  management  of  the  acquired 
companies and are inherently uncertain. 

We account for contingent consideration in accordance with applicable guidance provided within the business combination accounting 
standard. As part of our consideration for the recent acquisitions, we are contractually obligated to pay certain consideration resulting 
from the outcome of future events. Therefore, we are required to update our underlying assumptions each reporting period, based on 
new developments, and record such contingent consideration liabilities at fair value until the contingency is resolved. Changes in the 
fair value of the contingent consideration liabilities are recognized each reporting period and included in our consolidated statements 
of operations.  Our estimates of fair value are based on assumptions we believe to be reasonable, but the assumptions are uncertain and 
involve  significant  judgment  by  management.    Updates  to  these  assumptions  could  have  a  significant  impact  on  our  results  of 
operations  in  any  given  period  and  any  updates  to  the  fair  value  of  the  contingent  consideration  could  differ  materially  from  the 
previous estimates.

Examples of critical estimates used in valuing certain intangible assets and contingent consideration include: 

• 

• 

• 

• 

future expected cash flows from sales and acquired developed technologies;

the  acquired  company's  trade  name  and  customer  relationships  as  well  as  assumptions  about  the  period  of  time  the 
acquired trade name and customer relationships will continue to be used in the combined company's portfolio;

the probability of meeting the future events; and

discount rates used to determine the present value of estimated future cash flows.

These estimates are inherently uncertain and unpredictable, and if different estimates were used the purchase price for the acquisition 
could be allocated to the acquired assets and liabilities differently from the allocation that we have made. In addition, unanticipated 
events and circumstances may occur, which may affect the accuracy or validity of such estimates, and if such events occur we may be 
required  to  record  a  charge  against  the  value  ascribed  to  an  acquired  asset  or  an  increase  in  the  amounts  recorded  for  assumed 
liabilities.

Research and Development 

Research  and  development  expenses  consist  of  costs  incurred  in  performing  research  and  development  activities,  including  salaries 
and benefits, facilities expenses, overhead expenses, clinical trial and related clinical manufacturing expenses, contract services and 
other outside expenses. Research and development costs are charged to expense as incurred. 

Advertising Expenses 

Advertising costs are charged to expense as incurred. During 2020, 2019, and 2018, we incurred $1,126, $468, and $745, respectively, 
in advertising expenses.     

Stock-Based Compensation 

We  account  for  stock-based  compensation  to  employees  and  directors  using  the  fair  value  method.  We  recognize  compensation 
expense  for  stock  option  and  restricted  stock  awards  issued  to  employees  and  directors  on  a  straight-line  basis  over  the  requisite 
service  period  of  the  award.  We  recognize  compensation  expense  related  to  performance-based  restricted  stock  units  based  on 
F-15

assumptions as to what percentage of each performance target will be achieved. We evaluate these target assumptions on a quarterly 
basis and adjust compensation expense related to these awards, as appropriate. To satisfy the exercise of options, issuance of restricted 
stock, or redemption of performance-based restricted stock units, we issue new shares rather than purchase shares in the open market. 

Income Taxes 

We follow the asset and liability method for accounting for income taxes. Under this method, deferred tax assets and liabilities are 
recognized  for  the  future  tax  consequences  attributable  to  differences  between  the  financial  statement  carrying  amounts  of  existing 
assets and liabilities and the respective tax basis of assets and liabilities, as well as operating loss and credit carryforwards. Deferred 
tax assets and liabilities are measured using enacted tax rates for the respective taxing jurisdiction that are expected to apply to taxable 
income in the years in which those temporary differences and operating loss and credit carryforwards are expected to be recovered, 
settled or utilized. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that 
includes the enactment date. 

We assess the realizability of our net deferred tax assets on a quarterly basis. If, after considering all relevant positive and negative 
evidence,  it  is  more  likely  than  not  that  some  portion  or  all  of  the  net  deferred  tax  assets  will  not  be  realized,  we  reduce  our  net 
deferred tax assets by a valuation allowance. The realization of the net deferred tax assets is dependent on several factors, including 
the generation of sufficient taxable income prior to the expiration of our net operating loss carryforwards. 

Foreign Currency Translation 

The assets and liabilities of our foreign  operations  are  translated into  U.S. dollars at current exchange  rates as  of  the  balance sheet 
date, and revenues and expenses are translated at average exchange rates for the period. Resulting translation adjustments are reflected 
in accumulated other comprehensive loss, which is a separate component of stockholders’ equity. 

Transaction  gains  and  losses  resulting  from  exchange  rate  changes  on  transactions  denominated  in  currencies  other  than  functional 
currency  are  included  in  our  consolidated  statements  of  operations  in  the  period  in  which  the  change  occurs.  Net  foreign  exchange 
gains (losses) resulting from foreign currency transactions that are included in other income (expense) in our consolidated statements 
of operations were $(337), $(1,339), and $831 for the years ended December 31, 2020, 2019, and 2018, respectively. 

Earnings (Loss) Per Share 

Basic earnings (loss) per share is computed by dividing net income (loss) by the weighted-average number of shares of common stock 
outstanding  during  the  period.  Diluted  earnings  (loss)  per  share  is  computed  in  a  manner  similar  to  basic  earnings  (loss)  per  share 
except that the weighted-average number of shares outstanding is increased to include incremental shares from the assumed vesting or 
exercise of dilutive securities, such as common stock options, unvested restricted stock or performance stock units, unless the impact 
is  antidilutive.  The  number  of  incremental  shares  is  calculated  by  assuming  that  outstanding  stock  options  were  exercised  and 
unvested  restricted  shares  and  performance  stock  units  were  vested,  and  the  proceeds  from  such  exercises  or  vesting  were  used  to 
acquire shares of common stock at the average market price during the reporting period. Basic and dilutive computations of net loss 
per share are the same in periods in which a net loss exists as the dilutive effects of excluded items would be anti-dilutive.

The computations of basic and diluted earnings (loss) per share are as follows: 

Net income (loss) .......................................................................................................  $(14,922
Weighted average shares of common stock outstanding:

  Year ended December 31,
    2019
  2020
)   $16,656

    2018
    $20,396

Basic .....................................................................................................................    67,505

      61,675

      61,112

Dilutive effect of stock options, restricted stock, and
   performance stock units ...............................................................................    —
Diluted ..................................................................................................................    67,505

      495
      62,170

      1,420
      62,532

Earnings (loss) per share:

Basic .....................................................................................................................  $(0.22
Diluted ..................................................................................................................  $(0.22

)   $0.27
)   $0.27

    $0.33
    $0.33

For the year ended December 31, 2020, outstanding common stock options, unvested restricted stock, and unvested performance stock 
units representing 984 shares were excluded from the computation of diluted loss per share.

F-16

 
 
 
 
 
     
       
       
 
 
 
 
     
       
       
 
 
 
For  the  years  ended  December 31,  2019,  and  2018,  outstanding  common  stock  options,  unvested  restricted  stock,  and  unvested 
performance stock units representing 768 and 291 shares, respectively, were excluded from the computation of diluted earnings per 
share as their inclusion would have been anti-dilutive.

Accumulated Other Comprehensive Loss 

We classify items of other comprehensive income (loss) by their nature and disclose the accumulated balance of other comprehensive 
loss separately from accumulated deficit and additional paid-in capital in the stockholders’ equity section of our consolidated balance 
sheets. 

We have defined the Canadian dollar as the functional currency of our Canadian subsidiary, DNAG, and we have defined the Euro as 
the functional currency of our Belgian subsidiary, Novosanis. The results of operations are translated into U.S. dollars, which is the 
reporting  currency  of  the  Company.  Accumulated  other  comprehensive  loss  at  December 31,  2020  consists  of  $8,749  of  currency 
translation adjustments and $348 of net unrealized losses on marketable securities, which represents the fair market value adjustment 
for  our  investments  portfolio.  Accumulated  other  comprehensive  loss  at  December 31,  2019  consists  of  $12,022  of  currency 
translation adjustments and $114 of net unrealized losses on marketable securities. 

Recent Accounting Pronouncements  

 In  June  2016,  the  FASB  issued  guidance  on  the  measurement  of  credit  losses,  which  requires  measurement  and  recognition  of 
expected credit losses for financial assets, including trade receivables and capital lease receivables, held at the reporting date based on 
historical experience, current conditions, and reasonable and supportable forecasts. The method to determine a loss requires a credit 
loss to be recognized when it is probable. We adopted this guidance in the first quarter of 2020 and the impact of the adoption was not 
material  to  the  Company's  consolidated  financial  statements  as  credit  losses  are  not  expected  to  be  significant  based  on  historical 
collection  trends,  the  financial  condition  of  payment  partners,  and  external  market  factors.  The  Company  will  continue  to  actively 
monitor the impact of the coronavirus (COVID-19) pandemic on expected credit losses. In addition, the new guidance requires us to 
record an allowance for credit loss when a decline in investment market value is due to credit-related factors. As of January 1, 2020, 
there was no material decline in the market value of available-for-sale investments due to credit-related factors.

In February 2018, the FASB issued guidance allowing a reclassification from accumulated other comprehensive income to retained 
earnings for stranded tax effects resulting from the U.S. Tax Cuts and Jobs Act. If elected, the reclassification can be applied in either 
the period of adoption or retrospectively to the period of the enactment of the U.S. Tax Cuts and Jobs Act (i.e., our first quarter of 
fiscal  year  2018). We  adopted  this  guidance  in  the  first  quarter  of  2020  and  the  impact  of  the  adoption  was  not  material  to  the 
Company's consolidated financial statements.

In August 2018, the FASB issued guidance related to fair value measurement disclosures. This guidance removes the requirement to 
disclose the amount of and reasons for transfers between Levels 1 and 2 of the fair value hierarchy, the policy for determining that a 
transfer  has  occurred,  and  valuation  processes  for  Level  3  fair  value  measurements.  Additionally,  this  guidance  modifies  the 
disclosures  related  to  the  measurement  uncertainty  for  recurring  Level  3  fair  value  measurements  (by  removing  the  requirement  to 
disclose sensitivity to future changes) and the timing of liquidation of invested assets (by removing the timing requirement in certain 
instances). The guidance also requires new disclosures for Level 3 financial assets and liabilities, including the amount and location of 
unrealized  gains  and  losses  recognized  in  other  comprehensive  income(loss) and  additional  information  related  to  significant 
unobservable inputs used in determining Level 3 fair value measurements. We adopted this guidance in the first quarter of 2020 and 
the impact of the adoption was not material to the Company's consolidated financial statements.

3. BUSINESS COMBINATIONS

UrSure

On July 22, 2020, the Company acquired all of the outstanding stock of UrSure, Inc. (“UrSure”), pursuant to the terms of a merger 
agreement.  The  initial  aggregate  purchase  price  of  this  transaction  was  $3,000,  adjusted  for  certain  transaction  costs,  indebtedness, 
and holdback amounts, and was funded with cash on hand. A portion of the purchase price was deposited into an escrow account for a 
limited period after closing, pursuant to indemnification obligations under the merger agreement.

Pursuant to our acquisition agreements, we may pay up to an additional $28,000 of contingent consideration over the next four years 
based  on  the  achievement  of  certain  performance  criteria  as  defined  under  the  agreements,  including  generating  certain  revenue 

F-17

          
 
dollars, and the achievement of certain clinical milestones associated with the development of certain new technology. The Company, 
with  the  assistance  of  an  independent  valuation  specialist,  determined  the  estimated  acquisition-date  fair  value  of  the  acquisition-
related  contingent  consideration  of  $3,440. The  fair  value  was  determined  using  a  probability-weighted  model  based  on  our 
assessment of the likelihood that the benchmarks will be achieved. The probability-weighted payments were then discounted using a 
discount rate based on an internal rate of return analysis using the probability-weighted cash flows. The fair value measurement was 
based on significant inputs, including the likelihood of the achievement of clinical milestones and revenue forecasts, not observable in 
the market and thus represents a Level 3 measurement within the fair value hierarchy. The fair value of the contingent consideration 
obligation changed from $3,440 as of the acquisition date to $2,451 as of December 31, 2020 largely due to changes in the timing of 
achieving certain clinical milestones.

During the year ended December 31, 2020, we incurred a total of $393 of acquisition related costs, including accounting, legal, and 
other  professional  fees,  all  of  which  were  expensed  and  reported  as  a  component  of  general  and  administrative  expense  in  the 
consolidated statement of operations for the year ended December 31, 2020.The following table summarizes the estimated fair values 
of the assets acquired and liabilities assumed as of the acquisition date:

Assets Acquired

Accounts receivable ............................................................................................................................... 
Other current assets................................................................................................................................ 
Other assets ............................................................................................................................................ 
Intangibles.............................................................................................................................................. 
Goodwill ................................................................................................................................................ 
Total assets acquired......................................................................................................................... 

Liabilities Assumed

Current liabilities ................................................................................................................................... 
Deferred tax liability .............................................................................................................................. 
Total liabilities assumed ................................................................................................................... 
Net Assets Acquired................................................................................................................................ 
Estimated fair value of contingent consideration ..................................................................................... 
Net Cash Paid (net of cash acquired of $111)....................................................................................... 

$285
  24
  6
  3,600
  3,586
  7,501

  335
  689
  1,024
  6,477
  (3,440
$3,037

)

The  purchase  price  was  allocated  to  the  tangible  assets  and  identifiable  intangible  assets  acquired  and  liabilities  assumed  based  on 
their  acquisition-date  estimate  fair  values.  The  identifiable  intangible  assets  principally  included  developed  technology,  which  is 
subject to amortization on a straight-line basis and is being amortized over a ten year estimated useful life.

The Company, with the assistance of an independent valuation specialist, assessed the fair value of the assets of UrSure. The income 
approach was used to value the acquired intangibles and the fair value measurements were primarily based on significant inputs that 
are not observable in the market and are considered Level 3 fair value measurements. The income approach estimates fair value for an 
asset based on the present value of cash flows projected to be generated by the asset.  Projected cash flows are discounted at a required 
rate of return that reflects the relative risk of achieving the cash flows and the time value of money.

The  useful  lives  of  the  intangible  assets  were  estimated  based  on  the  expected  future  economic  benefit  of  the  assets  and  are  being 
amortized over the estimated useful life in proportion to the economic benefits consumed using the straight-line method.  

The amortization of intangible assets is not deductible for income tax purposes.

Goodwill is calculated as the difference between the acquisition date fair value of the consideration transferred and the fair value of 
the net assets acquired, and represents the future economic benefits that we expect to achieve as a result of the acquisition. We believe 
the goodwill related to the acquisition was a result of gaining a complementary product offering that will enable us to leverage those 
products  with  existing  and  new  customers.  The  goodwill  is  not  deductible  for  income  tax  purposes.  All  of  the  goodwill  identified 
above has been allocated to our Diagnostics segment.

We  continue  to  evaluate  the  fair  value  of  certain  assets  acquired  and  liabilities  assumed,  related  to  the  acquisition.  Additional 
information that existed as of the acquisition date, but was at that time unknown to us, may become known during the remainder of the 
measurement period. Changes to amounts recorded as a result of the final determination may result in a corresponding adjustment to 
these assets and liabilities, including goodwill. The determination of the estimated fair values of all assets acquired is expected to be 
completed within one year from the date of acquisition.

F-18

 
   
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
Revenues  from  UrSure  primarily  consist  of  grant  money  received  to  fund  the  development  of  certain  new  technology  and 
approximated  $842  since  acquisition.  Effective  as  of  July  22,  2020,  the  financial  results  of  UrSure  are  included  in  our  Diagnostics 
segment. 

Diversigen

On  November  8,  2019,  the  Company  acquired  all  of  the  outstanding  stock  of  Diversigen  pursuant  to  the  terms  of  a  merger 
agreement. The  aggregate  purchase  price  for  this  transaction  was  $12,000,  adjusted  for  certain  transaction  costs,  indebtedness,  and 
holdback amounts, and was funded with cash on hand. A portion of the purchase price was deposited into an escrow account for a 
limited period after closing, pursuant to indemnification obligations under the merger agreement noted above. 

During the year ended December 31, 2019, we incurred a total of $1,198 of acquisition related costs, including investment banking fees 
and accounting, legal and other professional fees, all of which were expensed and reported as a component of general and administrative 
expenses in the consolidated statement of operations for the year ended December 31, 2019. 

Pursuant  to  the  merger  agreement,  we  were  to  pay  up  to  an  additional  $1,500  of  contingent  consideration  in  2020  based  on  the 
achievement of certain 2019 revenue metrics as defined under the agreements which did not occur. 

The  following  table  summarizes  the  preliminary  estimated  fair  values  of  the  assets  acquired  and  liabilities  assumed  as  of  the 
acquisition date:

Assets Acquired

Accounts receivable ............................................................................................................................... 
Other current assets................................................................................................................................ 
Property, plant, and equipment, net ....................................................................................................... 
Acquired intangible assets ........................................................................................................................ 
Goodwill ................................................................................................................................................... 
Total assets acquired......................................................................................................................... 

Liabilities Assumed

Current liabilities ................................................................................................................................... 
Deferred tax liability .............................................................................................................................. 
Other long-term liabilities...................................................................................................................... 
Total liabilities assumed ................................................................................................................... 
Net Assets Acquired................................................................................................................................ 
Estimated fair value of contingent consideration ..................................................................................... 
Net Cash Paid (net of cash acquired of $479)....................................................................................... 

$1,234
  45
  1,916
  3,560
  6,317
  13,072

  1,123
  598
  893
  2,614
  10,458
  -
$10,458

The  purchase  price  was  allocated  to  the  tangible  assets  and  identifiable  intangible  assets  acquired  and  liabilities  assumed  based  on 
their  acquisition-date  estimate  fair  values.  The  identifiable  intangible  assets  included  customer  relationships  and  tradenames,  all  of 
which are subject to amortization on a straight-line basis and are being amortized over estimated useful lives as summarized below:

Description
Customer relationships .................................................................................................  10
Tradenames ..................................................................................................................  9
Total acquired intangibles ............................................................................................ 

  Estimated Useful
  Life (in yrs)

  Amount
    2,900
  660
  $3,560

The  Company,  with  the  assistance  of  an  independent  valuation  specialist,  assessed  the  fair  value  of  the  assets  of  Diversigen. The 
income  approach  was  used  to  value  the  acquired  intangibles  and  the  fair  value  measurements  were  primarily  based  on  significant 
inputs that are not observable in the market and are considered Level 3 fair value measurements. The income approach estimates fair 
value for an asset based on the present value of cash flows projected to be generated by the asset.  Projected cash flows are discounted 
at a required rate of return that reflects the relative risk of achieving the cash flows and the time value of money.

The  useful  lives  of  the  intangible  assets  were  estimated  based  on  the  expected  future  economic  benefit  of  the  assets  and  are  being 
amortized over the estimated useful life in proportion to the economic benefits consumed using the straight-line method.  

F-19

 
 
 
   
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
The amortization of intangible assets is not deductible for income tax purposes.

Goodwill is calculated as the difference between the acquisition date fair value of the consideration transferred and the fair value of 
the net assets acquired, and represents the future economic benefits that we expect to achieve as a result of the acquisition. We believe 
the goodwill related to the acquisitions was a result of providing us a complementary service and product offering that will enable us 
to leverage those services and products with existing and new customers.  The goodwill is not deductible for income tax purposes.  All 
of the goodwill identified above has been allocated to our Molecular Solutions segment.

Revenues from Diversigen primarily consist of microbiome laboratory services that provide metagenomics sequencing, bioinformatics 
and  statistical  analysis  for  the  study  of  the  microbiome.  Effective  as  of  November  8,  2019,  the  financial  results  of  Diversigen  are 
included  in  our  Molecular  Solutions  segment. For  the  year  ended  December 31, 2019,  consolidated  net  revenues  include  revenues 
associated with the Diversigen business of $1,046 and consolidated results from operations include a net loss of $47 generated since 
the acquisition date.   

CoreBiome and Novosanis

On January 4, 2019, the Company acquired all of the outstanding stock of CoreBiome, pursuant to the terms of a merger agreement, 
dated January 3, 2019. CoreBiome has subsequently been merged into Diversigen in December 2020. Also on January 4, 2019, the 
Company,  through  a  wholly-owned  subsidiary,  acquired  all  of  the  outstanding  stock  of  Novosanis,  pursuant  to  a  share  purchase 
agreement, dated January 3, 2019. We began operating these entities as of the January 4, 2019 closing date. The aggregate purchase 
price for both of these transactions was $13,320 adjusted for certain transaction costs, indebtedness, and holdback amounts, and was 
funded with cash on hand. A portion of the purchase price was deposited into escrow accounts for a limited period after closing, in 
order to secure the potential payment of certain indemnification obligations of the selling stockholders under each agreement noted 
above.

During  the  year  ended  December  31,  2019,  we  incurred  a  total  of  $639  of  acquisition-related  costs  in  connection  with  these 
acquisitions,  including  success-based  investment  banking  fees  and  accounting,  legal  and  other  professional  fees,  related  to  both 
acquisitions,  all  of  which  were  expensed  and  reported  as  a  component  of  general  and  administrative  expenses  in  the  consolidated 
statement of operation.

Pursuant to our acquisition agreements, we were to pay up to an additional $32,400 of contingent consideration over three years based 
on the achievement of certain performance criteria as defined under the agreements, including generating certain revenue dollars, the 
achievement of a large customer contract, and the development of certain new technology. The Company, with the assistance of an 
independent  valuation  specialist,  utilized  a  Monte  Carlo  simulation  to  determine  the  estimated  acquisition-date  fair  value  of  the 
acquisition-related  contingent  consideration  of  $4,350. The  simulation  calculated  the probability-weighted  payments  based  on  our 
assessment of the likelihood that the benchmarks will be achieved. The probability-weighted payments were then discounted using a 
discount rate based on an internal rate of return analysis using the probability-weighted cash flows. The fair value measurement was 
based  on  significant  inputs,  including  revenue  forecasts,  not  observable  in  the  market  and  thus  represents  a  Level  3  measurement 
within  the  fair  value  hierarchy. The  fair  value  of  the  contingent  consideration  obligation  changed  from $4,350  as  of  the  acquisition 
date to $3,612 as of December 31, 2019.  This change was a result of changes in our estimated revenue forecasts and an amendment to 
one of the agreements, entered into in October 2019, in which management agreed to settle the contingent consideration associated 
with one of the acquisition’s 2019 results for $3,500. The fair value of the contingent consideration obligation changed from $3,612 as 
of December 31, 2019 to $0 as of December 31, 2020.  This change is a result of a $3,500 payment made in the first quarter of 2020, 
changes  in  our  estimated  revenue  forecasts  and  an  amendment  to  one  of  the  agreements.  As  of  December  31,  2020,  and  based  on 
current  and  forecasted  revenue  results,  it  is  not  expected  than  any  further  contingent  consideration will  be  paid  through  the  final 
potential payment date of July 2021.

F-20

The following table summarizes the estimated fair values of the assets acquired and liabilities assumed as of the acquisition date:

Assets Acquired

Accounts receivable ..............................................................................................................................  
Inventories.............................................................................................................................................  
Other current assets ...............................................................................................................................  
Property, plant, and equipment, net ......................................................................................................  
Other assets ...........................................................................................................................................  
Acquired intangible assets .......................................................................................................................  
Goodwill .................................................................................................................................................. 
Total assets acquired........................................................................................................................  

Liabilities Assumed

Current liabilities...................................................................................................................................  
Notes payable, short-term .....................................................................................................................  
Deferred tax liability .............................................................................................................................  
Other long-term liabilities .....................................................................................................................  
Total liabilities assumed ..................................................................................................................  
Net Assets Acquired............................................................................................................................... 
Estimated fair value of contingent consideration.....................................................................................  
Net Cash Paid (net of cash acquired of $103)...................................................................................... 

$ 791
  310
  82
  414
  5
  8,400
  10,368
  20,370

  1,180
  730
  819
  74
  2,803
  17,567
  (4,350
$ 13,217

)

The  purchase  price  was  allocated  to  the  tangible  assets  and  identifiable  intangible  assets  acquired  and  liabilities  assumed  based  on 
their  acquisition-date  estimate  fair  values.  The  identifiable  intangible  assets  principally  included  developed  technology,  customer 
relationships, and tradenames, all of which are subject to amortization on a straight-line basis and are being amortized over estimated 
useful lives as summarized below:

Description
Developed Technology...................................................................................................  10
Customer relationships ...................................................................................................  10
Tradenames.....................................................................................................................  8.34
Total acquired intangibles............................................................................................... 

  Amount
  $5,000
    2,200
  1,200
  $8,400

  Estimated Useful  
  Life (in yrs)

The  Company,  with  the  assistance  of  an  independent  valuation  specialist,  assessed  the  fair  value  of  the  assets  of  CoreBiome  and 
Novosanis. The income approach was used to value the acquired intangibles and the fair value measurements were primarily based on 
significant  inputs  that  are  not  observable  in  the  market  and  are  considered  Level  3  fair  value  measurements.  The  income  approach 
estimates fair value for an asset based on the present value of cash flows projected to be generated by the asset.  Projected cash flows 
are discounted at a required rate of return that reflects the relative risk of achieving the cash flows and the time value of money.

The  useful  lives  of  the  intangible  assets  were  estimated  based  on  the  expected  future  economic  benefit  of  the  assets  and  are  being 
amortized over the estimated useful life in proportion to the economic benefits consumed using the straight-line method.  

The amortization of intangible assets is not deductible for income tax purposes.

Goodwill is calculated as the difference between the acquisition date fair value of the consideration transferred and the fair value of 
the net assets acquired, and represents the future economic benefits that we expect to achieve as a result of the acquisition. We believe 
the goodwill related to the acquisitions was a result of providing us a complementary service and product offering that will enable us 
to leverage those services and products with existing and new customers. The goodwill is not deductible for income tax purposes. All 
of the goodwill identified above has been allocated to our Molecular Solutions segment.

Revenues  from  CoreBiome  primarily  consist  of  microbiome  laboratory  services  that  utilize  optimal  analytical  algorithms  to  deliver 
speed  and  scalability  in  the  lab  with  precise  analytics.  Revenues  from  Novosanis  primarily  consist  of  the  sale  of  its  Colli-Pee 
collection device which was designed for the standard collection of first-void urine used in the liquid biopsy and sexually transmitted 
infection  screening  market.  Effective  as  of  January  4,  2019,  the  financial  results  of  CoreBiome  and  Novosanis  are  included  in  our 
F-21

 
 
   
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
Molecular  Solutions  segment.  For  the  year  ended  December 31, 2019,  consolidated  net  revenues  include  combined  revenues 
associated with the CoreBiome and Novosanis business of $5,152. Consolidated results from operations for the year ended December 
31, 2019 included a net loss of $2,450 generated from the combined companies since the acquisition date.  

Unaudited Pro Forma Financial Information

The unaudited pro forma results presented below include the results of the CoreBiome, Diversigen,  Novosanis acquisitions as if they 
had been consummated as of January 1, 2018 and the results of UrSure as if it had been consummated as of January 31, 2019. The 
unaudited  pro  forma  results  include  the  amortization  associated  with  acquired  intangible  assets  and  the  estimated  tax  effect  of 
adjustments to income before income taxes but do not include changes in the fair value of our contingent consideration obligations. 
Material  nonrecurring  charges,  directly  attributable  to  the  transactions,  including  direct  acquisition  costs,  are  also  excluded.  In 
addition,  the  unaudited  pro  forma  results  do  not  include  any  expected  benefits  of  the  acquisitions.  Accordingly,  the  unaudited  pro 
forma  results  are  not  necessarily  indicative  of  either  future  results  of  operations  or  results  that  might  have  been  achieved  had  the 
acquisitions been consummated as of the January 1, 2018 and 2019 dates.

  Year Ended December 31,

2020

  2019

Revenue....................................................................... 
Net income .................................................................. 
Net income per share, basic ........................................ 
Net income per share, diluted ..................................... 

$172,563
  (14,937
  (0.22
  (0.22

  $159,632
)   16,261
)   0.26
)   0.26

  2018

  $190,487
    19,448
    0.32
    0.31

4.    SALE OF CRYOSURGICAL BUSINESS

On August 16, 2019, we sold all rights and title to the assets necessary to operate our cryosurgical systems line of business to 
 a third party for $12,000.  This business consisted of medical devices used for the removal of benign skin lesions by cryosurgery or 
freezing. The products were sold in both the professional and OTC markets in North America, Europe, Central and South America and 
Australia.  We  also  entered  into  a  transition  services  agreement  with  CryoConcepts  in  which  both  parties  agreed  to  provide  certain 
transition services beginning after the closing.  The Company recorded a gain on sale of business of $10,149 reflected in our statement 
of income for the year ended December 31, 2019. The gain includes the $12,000 of proceeds net of the fair value of the assets sold, 
which  consisted  entirely  of  inventory  and  fully-depreciated  fixed  assets,  the  legal  fees  associated  with  the  transaction,  and  a  value 
attributed to the transition services.

5.

INVENTORIES: 

Raw materials .............................................................................  $
Work in process ..........................................................................   
Finished goods ............................................................................   
 $

15,425   $
2,572    
13,866    
31,863   $

14,168 
643 
8,344 
23,155  

December 31,

2020

2019

F-22

 
 
 
 
 
 
 
   
     
     
 
 
 
 
 
 
 
 
 
 
   
 
 
6.

PROPERTY, PLANT AND EQUIPMENT: 

Land ............................................................................................  $
Buildings and improvements ......................................................   
Machinery and equipment ..........................................................   
Computer equipment and software.............................................   
Furniture and fixtures .................................................................   
Construction in progress .............................................................   

Less accumulated depreciation ...................................................   
  $

December 31,

2020

2019

1,118    $
26,480     
36,878     
13,024     
3,545     
24,419     
105,464     
(53,604)   
51,860    $

1,118 
23,231 
33,568 
11,590 
2,791 
4,923 
77,221 
(46,882)
30,339  

Depreciation expense was $5,514, $4,421, and $3,828 for 2020, 2019, and 2018, respectively. 

7. GOODWILL AND OTHER INTANGIBLE ASSETS: 

The changes in goodwill are as follows: 

Balance as of January 1 ..............................................................   
Goodwill acquired during the year .............................................   
Purchase price adjustment ..........................................................   
Change related to foreign currency translation...........................   
Balance as of December 31 ........................................................   $

36,201     
3,586     
(126)   
690     
40,351    $

18,521 
16,811 
— 
869 
36,201  

December 31,

2020

2019

Intangible assets consist of the following: 

December 31, 2020

Amortization 
Period 
(Years)

Gross

Accumulated 
Amortization  

Net

Customer relationships ............................................................   
Patents and product rights .......................................................   
Developed technology ............................................................. 
Tradename ............................................................................... 

10    $
5     
7-10     
5-15     
     $

14,997    $
7,766     
16,603     
5,645     
45,011    $

(9,685)   $
(5,792)    
(8,880)    
(2,750)    
(27,107)   $

5,312 
1,974 
7,723 
2,895 
17,904  

Amortization
Period (Years) 

Gross

December 31, 2019
Accumulated
Amortization  

Customer relationships ............................................................   
Patents and product rights .......................................................   
Developed technology ............................................................. 
Tradename ............................................................................... 

10    $
10     
7-10     
5-15     
     $

14,731    $
5,400     
12,410     
5,553     
38,094    $

(8,054)   $
(5,158)    
(7,982)    
(2,226)    
(23,420)   $

Net

6,677 
242 
4,428 
3,327 
14,674  

 Amortization expense for 2020, 2019, and 2018 was $3,246, $2,522, and $2,623, respectively. 

F-23

 
 
 
 
 
   
 
 
   
 
 
 
 
 
 
   
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
     
 
     
 
     
 
 
 
   
 
   
 
 
 
 
 
 
 
 
 
 
 
 
   
Amortization expense for each of the five succeeding fiscal years and beyond is estimated as follows: 

2021 ...............................................................................................   
2022 ...............................................................................................   
2023 ...............................................................................................   
2024 ...............................................................................................   
2025 ...............................................................................................   
Beyond...........................................................................................   
  $

3,291 
2,345 
2,345 
2,302 
2,050 
5,571 
17,904  

8. ACCRUED EXPENSES: 

Payroll and related benefits ..................................................  $
Professional fees...................................................................   
Other.....................................................................................   
  $

14,769   $
978    
6,480    
22,227   $

6,088 
2,769 
5,431 
14,288 

December 31,

2020

2019

9.     LEASES:

In  February  2016,  the  FASB  issued  ASU  No.  2016-02, Leases.  The  standard  requires  lessees  to  recognize  lease  assets  and  lease 
liabilities on the balance sheet and requires expanded disclosures about leasing arrangements. We adopted this standard on January 1, 
2019 on a modified retrospective basis and did not restate comparative amounts.

We determine whether an arrangement is a lease at inception. We have operating and finance leases for corporate offices, warehouse 
space and equipment (including vehicles). As of December 31, 2020, we are the lessee in all agreements. Our leases have remaining 
lease terms of 1 to 7 years, some of which include options to extend the leases based on agreed upon terms, and some of which include 
options to terminate the leases within 1 year.

As most of our leases do not provide an implicit rate, we use our incremental borrowing rate based on the information available at the 
lease commencement date in determining the present value of lease payments.

We have lease agreements that contain both lease and non-lease components (e.g., common-area maintenance). For these agreements, 
we account for lease components separate from non-lease components.

The components of lease expense are as follows:

Operating Lease Cost ..........................................................................................................    $
Finance Lease Cost

    December 31, 2020     December 31, 2019  
964 
1,291    $

    Amortization of right-of use assets...............................................................................     
    Interest on lease liabilities ............................................................................................     
Total Finance Lease Cost ....................................................................................................    $

627     
72     
699    $

410 
36 
446  

Year ended

Year ended

Lease cost for the year ended December 31, 2018 was $1,461.

Supplemental cash flow information related to leases is as follows:

F-24

 
 
 
 
 
 
   
 
 
 
     
      
 
    
 
   
   
 
 
       
       
 
Cash paid for amounts included in the measurement of lease liabilities:

Operating cash flows from operating leases..................................................................   $
Operating cash flows from financing leases..................................................................    
Financing cash flows from financing leases..................................................................    

Non-cash activity
Right-of-use assets obtained in exchange for operating lease obligations ............................    
Right-of-use assets obtained in exchange for finance lease obligations ...............................    

1,280    $
72     
687     

498     
46     

937 
33 
442 

1,829 
2,069  

Year ended

Year ended

   December 31, 2020     December 31, 2019  

Right of use assets obtained include those assets acquired and entered into during 2020 and 2019.

Supplemental balance sheet information related to leases is as follows:

   December 31, 2020     December 31, 2019  

Operating Leases

Right-of-use assets............................................................................................................
Current lease liabilities................................................................................................
Non-current lease liabilities ........................................................................................
   Total operating lease liabilities.........................................................................................

   $

   $

Finance Leases

Right-of-use assets............................................................................................................
Current lease liabilities................................................................................................
Non-current lease liabilities ........................................................................................
   Total finance lease liabilities ............................................................................................

   $

   $

4,461    $
1,125     
3,591     
4,716    $

1,312    $
517     
895     
1,412    $

Weighted Average Remaining Lease Term
Weighted-average remaining lease term—operating leases ............................................................................
Weighted-average remaining lease term—finance leases................................................................................

Weighted Average Discount Rate
Weighted-average discount rate—operating leases .........................................................................................
Weighted-average discount rate—finance leases.............................................................................................

As of December 31, 2020, minimum lease payments by period are expected to be as follows:

Finance

Operating

2021..................................................................................................................................
2022..................................................................................................................................
2023..................................................................................................................................
2024..................................................................................................................................
2025..................................................................................................................................
Thereafter .........................................................................................................................
Total Minimum Lease Payments .....................................................................................
Less: imputed interest ......................................................................................................
Present Value of Lease Liabilities ................................................................................... $

566     
566     
337     
25     
4     
-     
1,498     
(86)    
1,412    $

4,996 
1,032 
4,206 
5,238  

1,951 
613 
1,372 
1,985  

4.45 
2.67 

4.28%
4.35%

1,332 
1,315 
874 
894 
520 
325 
5,260 
(544)
4,716  

F-25

 
  
   
 
 
      
       
 
      
       
 
 
      
       
 
    
    
      
       
 
    
    
      
 
    
    
 
      
 
      
 
    
    
 
 
 
 
 
 
 
 
 
 
 
 
 
10. INCOME TAXES: 

Income (loss) before income tax expense consists of the following: 

United States ..........................................................................  $(47,995
Foreign ...................................................................................    44,471
  $(3,524

The components of income tax expense are as follows: 

  Years Ended December 31,
  2020

    2019
)  $3,106
      18,225
)  $21,331

    2018
    $(11,728
      43,444
    $31,716

  Years Ended December 31,
  2020

    2019

    2018

Current

Federal ..............................................................................  $—
State ..................................................................................    (106
Foreign..............................................................................    11,896
    11,790

Deferred

Federal ..............................................................................    (20,946
State ..................................................................................    (1,053
Foreign..............................................................................    (410

    (22,409
Decrease in valuation allowance............................................    22,017

Total income tax expense.......................................................  $11,398

    (392

    $—
)    1,033
      5,099
      6,132

)    3,568
)    125
)    (697
)    2,996
      (4,453
)    (1,457
    $4,675

    $—
      155
      12,084
      12,239

      9,200
      1,011
)    (919
      9,292
)    (10,211
)    (919
    $11,320

)

)

)
)

For the years ended December 31, 2020, 2019, and 2018 we recorded foreign income tax expense of $12,185, $4,607, and $11,165, 
respectively. 

The  Tax  Cuts  and  Jobs  Act  imposed  a  U.S.  tax  on  GILTI  that  is  earned  by  certain  foreign  affiliates  owned  by  a  U.S.  shareholder 
effective  in  2018.  GILTI  is  generally  intended  to  impose  tax  on  the  earnings  of  a  foreign  corporation  that  are  deemed  to  exceed  a 
certain threshold return relative to the underlying tangible property. The GILTI computation for 2018 was completed and is reflected 
in  the  2018  income  tax  provision.  The  Company  has  made  a  policy  election  related  to  its  treatment  of  GILTI  and  will  treat  it  as  a 
current period expense in the reporting period in which the tax is incurred. 

Final  GILTI  regulations  were  released  in  2020.    Among  the  changes  was  a  GILTI  “High-Tax  Exception,”  which  allows  foreign 
income deemed taxed at a sufficient effective rate to be excluded from a US owner’s GILTI income. All foreign income in 2020 fell 
under this exception.  It is expected that foreign income will continue to qualify for the exception in future years.

F-26

 
 
 
 
 
 
 
 
 
 
 
     
       
       
 
 
 
 
 
 
     
       
       
 
 
 
 
 
 
 
A  reconciliation  of  the  statutory  United  States  federal  income  tax  rate  to  our  effective  tax  rate  for  each  of  the  years  ended 
December 31, 2020, 2019, and 2018 is as follows: 

  2020
    2019
Statutory U.S. federal income tax rate ...............................   21.0
  % 21.0
Deemed repatriation tax .....................................................   —
 —
GILTI tax............................................................................   —
 16.9
Nondeductible executive compensation.............................   (0.9
 0.4
Impact of share-based payment awards .............................   (12.4
 (5.3
Tax effect of foreign items .................................................   (70.7
 4.5
State income taxes, net of federal benefit ..........................   26.0
 4.0
U.S. and foreign tax credits ................................................   34.9
 (1.1
) 
Nondeductible transaction costs.........................................   (2.8
 1.6
Nondeductible expenses and other .....................................   (2.6
) 
 0.4
NOL adjustment due to change in GILTI regulations........   308.9    
 —
 (20.5
Change in valuation allowance, federal and state ..............   (624.8 ) 
Effective tax rate ................................................................   (323.4 )% 21.9

) 
) 
) 

) 

    2018
  % 21.0
 10.9
 22.2
 4.8
 0.6
 6.8
 2.8
 (1.0
 —
 (0.2
 —
 (32.2
) 
  % 35.7

) 

  %

) 

) 

) 
  %

Deferred  income  taxes  reflect  the  tax  effects  of  temporary  differences  between  the  basis  of  assets  and  liabilities  recognized  for 
financial  reporting  purposes  and  tax  purposes,  and  net  operating  loss  and  tax  credit  carryforwards.  Significant  components  of  our 
deferred tax assets (liabilities) as of December 31, 2020 and 2019 are as follows:    

Deferred tax assets (liabilities):

  2020

    2019

Net operating loss carryforwards ..........................................  $31,701
Inventories.............................................................................    1,593
Capitalized research and development costs.........................    746
Accruals and reserves currently not deductible.....................    3,200
Acquired intangible assets.....................................................    (3,870
Depreciation and amortization ..............................................    (2,695
Stock-based compensation ....................................................    1,354
Tax credit carryforwards .......................................................    3,354
Net deferred tax asset ............................................................    35,383
Valuation allowance..............................................................    (36,578
Net deferred tax liability .......................................................  $(1,195

    $9,897
      2,002
      1,183
      2,272
)    (3,525
)    (1,999
      1,777
      2,055
      13,662
)    (14,561
)  $(899

)
)

)
)

In assessing the realizability of our deferred tax asset, we consider all relevant positive and negative evidence in determining whether 
it is more likely than not that some portion or all of the deferred income tax assets will not be realized. The realization of the gross 
deferred tax assets is dependent upon several factors, including the generation of sufficient taxable income prior to the expiration of 
the  NOL  carryforwards.  In  2008,  we  established  a  full  valuation  allowance  against  our  U.S.  deferred  tax  asset,  and  management 
believes  the  full  valuation  allowance  is  still  appropriate  as  of  December 31,  2020  and  2019  since  the  facts  and  circumstances 
necessitating  the  allowance  have  not  changed.  As  a  result,  no  U.S.  federal  income  tax  benefit  was  recorded  for  the  years  ended 
December 31, 2020, 2019, or 2018.   

Our Federal NOL carryforwards expire as follows: 

Year of Expiration
2021 - 2031 ............................  $
2032 - 2037 ............................  $
Non-Expiring ......................... 

  NOLs

  $

26,317
45,072
64,865
136,254

 The Tax Reform Act of 1986 contains provisions under Internal Revenue Code (“IRC”) Section 382 that limit the annual amount of 
federal and state NOL carryforwards that can be used in any given year in the event a significant change in ownership. We do not 
believe that there is a Section 382 limitation that will impair our future ability to utilize NOLs to offset our future taxable income. We 

F-27

 
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
 
 
     
       
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
continue  to  review  ownership  changes  on  an  annual  basis  and  we  do  not  believe  we  have  had  a  subsequent  ownership  change  that 
would impact the NOLs. 

Effective January 1, 2018, there is a transition to a participation exemption system whereby distributions from foreign subsidiaries to 
U.S. shareholders are generally exempt from taxation. Our intention is to continue to permanently reinvest the historical undistributed 
earnings of our foreign subsidiary to the extent that we will not incur any additional tax expense associated with foreign withholding 
or other local tax expense on the future cash transfers. As such, deferred taxes have not been recorded on the unremitted earnings of 
the foreign subsidiary.

As of December 31, 2020, our gross unrecognized tax benefits totaled $1,172, and based upon the valuation allowance for our U.S. 
operations,  the  recognition  of  any  tax  benefit  would  not  impact  our  effective  tax  rate.  We  record  interest  and  penalties  related  to 
unrecognized tax benefits as a component of income tax expense. Interest and penalties were immaterial in 2020, 2019 and 2018. As a 
result of our net operating loss carryforward position, we are subject to audit by the Internal Revenue Service since our inception, as 
well as by several state jurisdictions for the years ended September 30, 1998 through December 31, 2020. 

A reconciliation of our unrecognized tax benefits is as follows: 

Balance as of January 1.............................................................  $
Additions for tax positions of prior periods ..............................   
Reductions for tax positions of prior periods............................   
Balance as of December 31.......................................................  $

1,308    $
1     
(137)   
1,172    $

1,676    $
4     
(372)   
1,308    $

1,663 
44 
(31)
1,676  

2020

2019

2018

11.

STOCKHOLDERS’ EQUITY: 

Stock-Based Awards 

We grant stock-based awards under the OraSure Technologies, Inc. Stock Award Plan, as amended (the “Stock Plan”). The Stock Plan 
permits  stock-based  awards  to  employees,  outside  directors  and  consultants  or  other  third-party  advisors.  Awards  which  may  be 
granted under the Stock Plan include qualified incentive stock options, nonqualified stock options, stock appreciation rights, restricted 
awards, performance awards and other stock-based awards. 

As of December 31, 2020, 5,595 shares were available for future grants under the Stock Plan. 

Under the terms of the Stock Plan, nonqualified stock options may be granted to eligible employees, including our officers at a price 
not  less  than  75 percent  of  the  fair  market  value  of  a  share  of  common  stock  on  the  date  of  grant.  The  option  term  and  vesting 
schedule  of  such  awards  may  be  either  unlimited  or  have  a  specified  period  in  which  to  vest  and  be  exercised.   To  date,  options 
generally  have  been  granted  with  ten-year  exercise  periods  and  an  exercise  price  not  less  than  the  fair  market  value  on  the  date  of 
grant. Options generally vest over four years, with one quarter of the options vesting one year after grant and the remainder vesting on 
a monthly basis over the next three years. 

The  fair  value  of  each  stock  option  was  estimated  on  the  date  of  the  grant  using  the  Black-Scholes  option-pricing  model  using  the 
following weighted-average assumptions: 

Black-Scholes Option Valuation Assumptions
Risk-free interest rate(1).............................................
Expected dividend yield ...........................................
Expected stock price volatility(2)...............................
Expected life of stock options (in years)(2) ...............

Years Ended December 31,
2020
 1.33
 —
 42
 5

    2019
 % 2.52
 —
 % 41
 5

    2018
 % 2.60
 —
 % 43
 6

 %

 %

(1)

(2)

Based on the constant maturity interest rate of U.S. Treasury securities whose term is consistent with the expected life of our 
stock options. 
Based upon historical experience. 

The weighted-average grant date fair value of stock options granted during the years ended December 31, 2020, 2019 and 2018 was 
$2.79, $5.19 and $9.15, respectively. 

F-28

 
 
   
   
 
 
   
   
  
  
  
  
  
   
Compensation expense recognized in the financial statements related to stock options was as follows: 

Total compensation cost during the year ..............................................................
Amounts capitalized into inventory during the year .............................................
Amounts recognized in cost of products sold for amounts
   previously capitalized ........................................................................................
Amounts charged against income .........................................................................

  Years Ended December 31,
  2020     2019     2018  
 $ 892   $ 1,161   $ 2,163 
(420)

(343)  

(466)  

360    

396 
 $ 786   $ 1,223   $ 2,139  

405    

The aggregate intrinsic value of options exercised during the years ended December 31, 2020, 2019, and 2018 (the amount by which 
the market price of the stock on the date of exercise exceeded the exercise price) was $3,117, $92, and $2,314, respectively. 

The following table summarizes the stock option activity under the Stock Plan: 

Weighted-
Average
Exercise Price Per
Share

Weighted-
Average
Remaining
Contractual Term
(in years)

Aggregate
Intrinsic
Value

  Options

Outstanding on January 1, 2020............................   
Granted ............................................................   
Exercised .........................................................   
Expired.............................................................   
Forfeited...........................................................   
Outstanding on December 31, 2020......................   
Vested or expected to vest as of December 31, 
2020.......................................................................   
Exercisable on December 31, 2020.......................   

1,193    
510    
(402)  
(5)  
(64)  
1,232   $

1,232   $
636   $

10.68   
7.16   
8.03   
8.73   
10.12   
10.12   

10.12   
11.62   

6.79  $

2,688 

6.79  $
4.87  $

2,688 
1,034  

As of December 31, 2020, there was $1,689 of unrecognized compensation expense related to unvested option awards that is expected 
to be recognized over a weighted-average period of 2.6 years. 

Net cash proceeds from the exercise of stock options were $3,222, $196 and $1701 for the years ended December 31, 2020, 2019, and 
2018, respectively. As a result of our net operating loss carryforward position, no actual income tax benefit was realized from stock 
option exercises for these periods. 

The following table summarizes information about stock options outstanding as of December 31, 2020: 

Options outstanding

Options exercisable

Range of exercise prices
$5.37 - $8.24 .........................................................   
$8.87 - $13.31 .......................................................   
$14.95 - $22.43 .....................................................   

Weighted-
Average
Remaining
Contractual
Term
(in years)

Weighted-
Average
Exercise
Price Per
Share

Weighted-
Average
Exercise
Price Per
Share

Number
Exercisable

7.7    $
5.8     
5.5     
6.8    $

6.94     
10.99     
19.19     
10.12     

182    $
276     
178     
636    $

6.30 
10.39 
18.97 
11.62  

Number

Outstanding    

665     
368     
199     
1,232     

The Stock Plan also permits us to grant restricted shares and restricted units of our common stock to eligible employees, including 
officers,  and  our  outside  directors.  Generally,  these  shares  or  units  are  nontransferable  until  vested  and  are  subject  to  vesting 
requirements  and/or  forfeiture,  as  determined  by  our  Compensation  Committee  or  Board  of  Directors.  The  market  value  of  these 
shares  and  units  at  the  date  of  grant  is  recognized  on  a  straight-line  basis  over  the  period  during  which  the  restrictions  lapse. 
Compensation  cost  of  $4,094  $2,979  and  $6,357  related  to  restricted  shares  was  recognized  during  the  years  ended  December 31, 
2020, 2019, and 2018, respectively. 

F-29

 
 
 
  
  
 
   
  
  
 
    
  
    
  
    
  
    
  
    
  
   
 
 
   
   
   
 
 
   
The following table summarizes restricted stock award and restricted stock units activity under the Stock Plan: 

Weighted-Average
Grant Date Fair
Value

Units

Issued and unvested, January 1, 2020 .....................................................   
Granted ..............................................................................................   
Vested ................................................................................................   
Forfeited.............................................................................................   
Issued and unvested, December 31, 2020 ...............................................   
Issued and expected to vest, December 31, 2020....................................   

464     
561     
(342)   
(24)   
659    $
659    $

12.86 
8.35 
11.14 
11.90 
9.95 
9.95  

As of December 31, 2020, there was $3,697 of unrecognized compensation expense related to unvested restricted stock awards and 
unvested restricted stock units that is expected to be recognized over a weighted average period of 1.7 years. 

In  connection  with  the  vesting  of  restricted  shares  during  the  years  ended  December 31,  2020,  2019  and  2018,  we  purchased  and 
immediately  retired  127,  76  and  171  shares  with  aggregate  values  of  $1,219,  $949  and  $3,291,  respectively,  in  satisfaction  of 
minimum tax withholding and exercise obligations. 

We  grant  performance-based  restricted  stock  units  (“PSUs”)  to  certain  executives.  Vesting  of  these  PSUs  is  dependent  upon 
achievement of performance-based metrics during a one-year or three-year period, from the date of grant. Assuming achievement of 
each  performance-based  metric,  the  executive  must  also  generally  remain  in  our  service  for  three  years  from  the  grant  date. 
Performance during the one-year period will be based on a one-year earnings per share or income before taxes target. If the one-year 
target  is  achieved,  the  PSUs  will  then  vest  three  years  from  grant  date.  Performance  during  the  three-year  period  will  be  based  on 
achievement of a three-year compound annual growth rate for consolidated product revenues. If the three-year target is achieved, the 
corresponding  PSUs  will  then  vest  three  years  from  grant  date.  PSUs  are  converted  into  shares  of  our  common  stock  once  vested. 
Upon grant of the PSUs, we recognize compensation expense related to these awards based on assumptions as to what percentage of 
each target will be achieved. The Company evaluates these target assumptions on a quarterly basis and adjusts compensation expense 
related to these awards, as appropriate. 

Compensation cost of $2,153, $(83) and $6,717 related to the PSUs was recognized during the years ended December 31, 2020, 2019 
and 2018, respectively. 

The following table summarizes PSU activity under the Stock Plan: 

Issued and unvested, January 1, 2020........................................................................................... 
Granted (1) ................................................................................................................................ 
Performance adjustment (2) ...................................................................................................... 
Vested...................................................................................................................................... 
Forfeited .................................................................................................................................. 
Issued and unvested, December 31, 2020..................................................................................... 
Issued and expected to vest, December 31, 2020.................................................................... 

Weighted-
Average Grant
Date Fair
Value

Units

525 
368 
104 
(311)
(35)
651 
651 

 $
 $

12.52 
7.57 
N/A 
8.87 
13.87 
11.30 
11.30  

1.

2.

Grant activity for all PSUs disclosed at target.
Reflects the performance adjustment based on actual performance measured at the end of the performance period.

In connection with the vesting of performance stock units during the year ended December 31, 2020, 2019 and 2018, we purchased 
and immediately retired 121, 213, and 20 shares with aggregate values of $869, $2,763 and $301, respectively.  

 Public Offering

On  June  1,  2020,  we  entered  into  an  underwriting  agreement  with  J.P.  Morgan  Securities  LLC,  Citigroup  Global  Markets  Inc.  and 
Evercore  Group  LLC,  as  representatives  of  several  underwriters,  relating  to  the  issuance  and  sale  of  8,000  shares  of  our  common 
stock. The price to the public in the offering was $11.00 per share. Under the terms of the underwriting agreement, we also granted the 
underwriters an option, exercisable for 30 days, to purchase up to an additional 1,200 shares of common stock. On June 3, 2020, we 
announced the full exercise by the underwriters of their option to purchase these additional shares. 

F-30

 
 
   
 
 
 
 
 
 
 
  
 
  
 
 
 
  
 
  
 
 
The  offering  was  made  pursuant  to  an  effective  registration  statement  on  Form S-3  (File  No. 333-228877)  we  had  previously  filed 
with  the  SEC,  and  a  prospectus  supplement  thereunder.  The  net  proceeds  from  the  offering  were  approximately  $95,000 after 
deducting underwriting discounts and offering expenses paid by the Company.

Share Repurchase Program 

On August 5, 2008, our Board of Directors approved a share repurchase program pursuant to which we are permitted to acquire up to 
$25,000 of our outstanding common shares. No shares were purchased and retired in 2020, 2019 or 2018.         

12.  TRANSITION COSTS

In January 2018, we announced the retirement of our President and CEO and our CFO and Chief Operating Officer.  Stephen S. Tang, 
Ph.D., who served as Chairman of the Board of Directors (the “Board”), was appointed as the Company’s new President and CEO, 
effective  as  of  April  1,  2018.    Dr.  Tang  replaced  Douglas  A.  Michels,  who  retired  as  President  and  CEO,  and  as  a  member  of  the 
Board, on March 31, 2018.  In addition, Roberto Cuca was appointed as the Company’s new CFO, effective June 8, 2018.  Mr. Cuca 
replaced Ronald H. Spair, our former CFO and Chief Operating Officer, who retired on that same date.  Charges associated with these 
transitions were $9,602 during 2018 and are included in general and administrative expenses in the consolidated statement of income.  
These charges primarily reflect non-cash charges associated with modifications to existing stock grants held by the retiring executives 
and expenses associated with the onboarding of the Company’s new President and CEO.  

13. BUSINESS SEGMENT INFORMATION: 

Our business consists of two segments: our “Diagnostics” business, which was previously named “OSUR”, primarily consists of the 
development, manufacture, marketing and sale of oral fluid diagnostic products and specimen collection devices using our proprietary 
technologies,  other  diagnostic  products  including  immunoassays  and  other  in  vitro  diagnostic  tests  that  are  used  on  other  specimen 
types. Our Diagnostics segment includes the financial results of UrSure. Our “Molecular Solutions” business, which was previously 
named “DNAG,” consists of the development, manufacture, marketing and sale of specimen collection kits that are used to collect, 
stabilize, transport and store samples of genetic material for molecular testing. Our collection kits are also used for the collection of 
first-void  urine  for  liquid  biopsy  in  the  prostate  and  bladder  cancer  markets;  and  in  the  sexually  transmitted  infection  screening 
market. In addition, our Molecular Solutions business provides microbiome laboratory services that accelerate research and discovery 
for  customers  in  the  pharmaceutical,  agricultural,  and  academic  research  markets.  Financial  results  of  Diversigen,  CoreBiome  and 
Novosanis  are  included  in  our  Molecular  Solutions  segment.  Our  cryosurgical  systems  business  was  included  in  our  Diagnostics 
segment and the impact of the sale of that business in August 2019 is reflected in the results presented below. 

We organized our operating segments according to the nature of the products included in those segments. The accounting policies of 
the segments are the same as those described in the summary of significant accounting policies (see Note 2). We evaluate performance 
of our operating segments based on revenue and operating income. We do not allocate interest income, interest expense, other income, 
other expenses or income taxes to our operating segments.  Reportable segments have no inter-segment revenues and inter-segment 
expenses have been eliminated.

Operating income (loss) for the year ended December 31, 2018 has been modified to conform to the classification of the intercompany 
service fee presentation for 2019.  Beginning with the first quarter of 2019, we have included the fees for intercompany services in our 
segment operating income (loss) in order to more accurately reflect the results of each segment.  

F-31

The following table summarizes operating segment information for the years ended December 31, 2020, 2019, and 2018, and asset 
information as of December 31, 2020 and 2019: 

2020

Years Ended December 31,
2019

2018

Net revenues:

Diagnostics.................................................................  $
Molecular Solutions ...................................................   
Total......................................................................  $

65,240    $
106,481     
171,721    $

78,225    $
76,380     
154,605    $

Operating income (loss):

Diagnostics.................................................................  $
Molecular Solutions ...................................................   
Total......................................................................  $

(43,156)  $
37,979     
(5,177)  $

154    $
18,457     
18,611    $

Depreciation and amortization:

Diagnostics.................................................................  $
Molecular Solutions ...................................................   
Total......................................................................  $

Capital expenditures:

Diagnostics.................................................................  $
Molecular Solutions ...................................................   
Total......................................................................  $

3,345    $
6,042     
9,387    $

17,860    $
8,814     
26,674    $

3,039    $
4,300     
7,339    $

6,073    $
3,241     
9,314    $

December 31,

2020

2019

85,635 
96,108 
181,743 

(15,188)
43,617 
28,429 

3,755 
3,467 
7,222 

4,893 
1,451 
6,344  

Total assets:

Diagnostics ............................................................................   $
Molecular Solutions ..............................................................    
Total .................................................................................   $

242,613   $
211,859    
454,472   $

163,943 
185,352 
349,295  

The following table represents total long-lived assets by geographic area: 

United States..............................................................................  $
Canada ....................................................................................... 
Other regions ............................................................................. 

  $

December 31,

2020

2019

36,897   $
10,616    
4,347    
51,860   $

23,846 
5,697 
796 
30,339  

14. COMMITMENTS AND CONTINGENCIES: 

        Purchase Commitments 

As  of  December 31,  2020,  we  had  outstanding  non-cancelable  purchase  commitments  related  to  inventory,  supplies,  capital 
expenditures, and other goods or services as follows: 

2021 ...............................................................................................    16,542
2022 ...............................................................................................    20
2023 ...............................................................................................    18

  $16,580

Employment Agreements 

Under terms of employment agreements with certain employees, which extend through 2024, we are required to pay each individual a 
base salary for continuing employment with us as follows:

F-32

 
 
 
 
 
   
   
 
     
       
       
 
     
       
       
 
     
       
       
 
     
       
       
 
 
 
 
 
 
   
 
     
      
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
2021 ...............................................................................................    2,947
2022 ...............................................................................................    1,213
2023 ...............................................................................................    409
2024 ...............................................................................................    —

  $4,569

         Litigation 

From time to time, we are involved in certain legal actions arising in the ordinary course of business. In management’s opinion, the 
outcomes  of  such  actions,  either  individually  or  in  the  aggregate,  are  not  expected  to  have  a  material  adverse  effect  on  our  future 
financial position or results of operations. 

On February 6, 2017, DNAG entered into a settlement and license agreement (the “Settlement Agreement”) in order to settle certain 
patent  infringement  and  breach  of  contract  litigation  against  Ancestry.comDNA,  LLC  (“Ancestry”)  and  its  contract  manufacturer.  
This litigation was related to a saliva DNA collection device sold by Ancestry that was similar to products sold by DNAG.  Under the 
terms  of  the  Settlement  Agreement,  DNAG  and  Ancestry  agreed  to  certain  procedures  for  considering  whether  future  versions  of 
Ancestry’s saliva DNA collection product are covered by the DNAG patents licensed to Ancestry (the “Licensed Patents”) and thus 
subject  to  ongoing  royalties  under  the  Settlement  Agreement.  A  dispute  arose  among  the  parties  regarding  whether  certain  new 
Ancestry  products  are  covered  by  the  Licensed  Patents.    Pursuant  to  the  terms  of  the  Settlement  Agreement,  a  binding  arbitration 
proceeding was commenced to resolve the dispute.  In February 2020, an arbitration panel issued a decision finding that the future 
Ancestry products do not infringe the DNAG patents asserted in the arbitration and would no longer be subject to the royalties under 
the Settlement Agreement.  

Following the completion of the arbitration, a new patent was issued to DNAG that is a continuation of a patent licensed to Ancestry 
and is thus a Licensed Patent under the Settlement Agreement.  DNAG notified Ancestry of this new patent and following discussions 
between  the  parties  Ancestry  initiated  a  new  arbitration  proceeding  during  the  third  quarter  of  2020  pursuant  to  the  Settlement 
Agreement with respect to the applicability of the new patent to the future Ancestry products and the validity of that patent. Following 
the initiation of the arbitration by Ancestry, DNAG filed a statement of defense and an objection to the arbitration on the basis that a 
dispute between the parties has not yet occurred and therefore the alleged dispute is not sufficiently ripe to arbitrate.  An arbitration 
panel has been appointed. The parties have since engaged in settlement discussions and the commencement of the arbitration has been 
delayed.

15. RETIREMENT PLANS: 

Substantially all of our U.S. employees are eligible to participate in the OraSure Technologies, Inc. 401(k) Plan (the “401(k) Plan”). 
The  401(k)  Plan  permits  voluntary  employee  contributions  to  be  excluded  from  an  employee’s  current  taxable  income  under 
provisions  of  Internal  Revenue  Code  Section 401(k)  and  the  regulations  thereunder.  The  401(k)  Plan  also  provides  for  us  to  match 
employee contributions up to $4 per year. We contributed $994, $754 and $721 to the 401(k) Plan, net of forfeitures, in 2020, 2019, 
and 2018, respectively. 

In addition to our 401(k) plan, we offer a nonqualified deferred compensation plan to permit eligible directors and highly compensated 
employees  of  the  Company  to  defer  receipt  and  taxation  of  their  compensation  each  year.  We  also  may  make  discretionary 
contributions to the accounts of the participating employees in any amount either in cash or stock. Participants in the plan may not 
purchase OraSure stock as an investment vehicle. As of December 31, 2020 and 2019, the value of the assets associated with this plan 
was  $2,565  and  $3,519,  respectively,  and  is  included  in  current  assets  and  other  assets  in  our  consolidated  balance  sheets.  Our 
obligation related to the deferred compensation plan is included in accrued expenses and other liabilities in our consolidated balance 
sheets. As of December 31, 2020 and 2019, our total obligation under this plan was $2,565 and $3,519, respectively. 

Substantially all regular full-time Canadian employees are eligible to participate in the DNA Genotek Registered Retirement Savings 
Plan (the “RRSP”). The RRSP permits voluntary employee contributions to be excluded from an employee’s current taxable income 
and receive tax preferred treatment with Revenue Canada. The RRSP also provides for DNAG to match employee contributions up to 
$4 per year. We contributed $366, $184 and $163 to the RRSP in 2020, 2019, and 2018, respectively. 

F-33

    
 
 
 
 
 
 
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