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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (unaudited) - USD ($) $ in Thousands | 9 Months Ended
--- | ---
Sep. 30, 2023 | Sep. 30, 2022
CASH FLOWS FROM OPERATING ACTIVITIES: |  |
Net income (loss) | $ 242,978 | $ (130,013)
Adjustments to reconcile net income (loss) to cash flows from operating activities: |  |
Depreciation and amortization | 56,386 | 58,185
Share-based compensation expense | 75,062 | 67,771
Deferred income taxes | (47,385) | (54,073)
Change in the fair value of contingent consideration |  | 21,750
Other non-cash charges | 1,394 | 3,746
Changes in assets and liabilities: |  |
Receivables | (49,730) | 56,045
Contract assets | 6,163 | 3,258
Inventory | (9,866) | (15,646)
Prepaid expenses and other assets | 3,947 | 1,872
Right-of-use assets | 12,685 | 12,470
Accounts payable and accrued expenses | 20,958 | 6,386
Accrued sales discounts, allowances and reserves | (13,649) | (1,576)
Contract liabilities | (5,724) | (9,191)
Operating lease liabilities | (12,569) | (13,411)
Other long-term liabilities | 13,466 | 12,424
Cash flows provided by operating activities | 294,116 | 19,997
CASH FLOWS FROM INVESTING ACTIVITIES: |  |
Additions of property, plant and equipment | (31,018) | (28,227)
Proceeds from the sale of equipment | 6 |
Proceeds from contingent consideration |  | 1,273
Return of Fountain Healthcare Partners II, L.P. investment |  | 485
Purchases of investments | (186,593) | (256,806)
Sales and maturities of investments | 291,944 | 190,994
Cash flows provided by (used in) investing activities | 74,339 | (92,281)
CASH FLOWS FROM FINANCING ACTIVITIES: |  |
Proceeds from the issuance of ordinary shares under share-based compensation arrangements | 15,113 | 18,850
Employee taxes paid related to net share settlement of equity awards | (26,080) | (17,903)
Principal payments of long-term debt | (2,250) | (2,250)
Cash flows used in financing activities | (13,217) | (1,303)
NET INCREASE (DECREASE) IN CASH AND CASH EQUIVALENTS | 355,238 | (73,587)
CASH AND CASH EQUIVALENTS—Beginning of period | 292,473 | 337,544
CASH AND CASH EQUIVALENTS—End of period | 647,711 | 263,957
Non-cash investing and financing activities: |  |
Purchased capital expenditures included in accounts payable and accrued expenses | $ 4,209 | $ 2,690

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