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INCOME TAXES
 6 Months Ended
Jun. 30, 2023
Income Tax Disclosure [Abstract]  
INCOME TAXES INCOME TAXES
Income before income taxes and income tax expense are as follows (dollar amounts in thousands):
Three Months Ended
June 30,		Six Months Ended
June 30,
2023202220232022
Income (loss) before income taxes:
   Domestic$40,189 $23,798 $12,416 $30,380 
   Foreign(2,335)(1,791)(1,036)(1,079)
Total income before income taxes$37,854 $22,007 $11,380 $29,301 
Income tax expense$12,091 $2,131 $5,153 $2,597 
Effective tax rate32 %10 %45 %9 %
The Company’s income tax expense represents the estimated annual effective tax rate applied to the year-to-date domestic operating results adjusted for certain discrete tax items.
The Company’s effective tax rates for the three and six months ended June 30, 2023 includes costs related to non-deductible stock-based compensation, a valuation allowance recorded against non-U.S. results and non-deductible executive compensation. The Company’s effective tax rate for the three and six months ended June 30, 2022 includes benefits related to stock-based compensation, a first quarter Skyepharma milestone payment and a fair value adjustment for Flexion contingent consideration, partially offset by nondeductible executive compensation costs and a valuation allowance against non-U.S. results.