This decrease of $731 thousand, or 1.9%, was primarily due to a $17.5 million decrease in our net loss and $2.1 million increase in
non-cash
expenditure adjustment, partially offset by $18.9 million in cash usage changes related to the components of working capital.
For the first quarter of 2021, net cash used in investing activities was $438 thousand, compared to net cash used in investing activities of $443 thousand for the first quarter of 2020.
Financing activities currently represent the principal source of our cash flow. For the first quarter of 2021, net cash provided by financing activities was $95.9 million, compared to net cash provided by financing activities of $48.8 million for the first quarter of 2020. The $47.1 million increase was primarily related to increased sales of our common stock, consisting of $150.9 million in net proceeds from sales of common stock in 2021, partially offset by a $50.0 million repayment of debt in 2021, a $3.8 million increase in the payment of debt financing fees in 2021, and $50.0 million in borrowing of debt in 2020.
Our net days sales outstanding (“DSO”) is calculated by dividing average gross accounts receivable less the reserve for doubtful accounts, chargebacks, and payment discounts by the average daily net product revenue during the last four quarters for each respective quarterly period. For the first quarter of 2021, our net DSO was 141 days, compared to 165 days for the fourth quarter of 2020 and 154 days for first quarter of 2020. Our gross DSO is calculated by dividing average gross accounts receivable by the average daily gross product revenue to distributors during the last four quarters for each respective quarterly period. For the first quarter of 2021, our gross DSO was 62 days, compared to 67 days for the fourth quarter of 2020 and 51 days for the first quarter of 2020. Our DSO have fluctuated and will continue to fluctuate in the future due to variety of factors, including longer payment terms associated with the continued commercialization of IMVEXXY, BIJUVA, and ANNOVERA and changes in the healthcare industry. Our exposure to credit losses may increase if our customers are adversely affected by changes in healthcare laws, coverage, and reimbursement, economic pressures or uncertainty associated with local or global economic recessions, disruption associated with the
COVID-19
pandemic, or other customer-specific factors. Although we have historically not experienced significant credit losses, it is possible that there could be a material adverse impact from potential adjustments of the carrying amount of trade receivables in the future.
We had $200.0 million and $250.0 million in term loans outstanding under the Financing Agreement as of March 31, 2021 and December 31, 2020, respectively. For additional information, see Note 8, Debt in Item 1, Financial Statements, appearing elsewhere in this
10-Q
Report.
The Financing Agreement requires us to maintain a minimum unrestricted cash balance of $60.0 million. As of the filing date of this
10-Q
Report, our cash balance was above the required minimum balance. Based on our current projections, along with financing that may be available to us under the 2021 ATM Program, we anticipate that we will remain in compliance with the minimum cash balance covenant for the next twelve months from the date of this
10-Q
Report. In addition, we have reviewed numerous potential scenarios in connection with the impact of
COVID-19
pandemic on our business, and we believe that our existing cash reserves are sufficient to meet our cash needs arising in the ordinary course of business for the next twelve months from the date of this
10-Q
Report. However, if we are unsuccessful with the commercialization of IMVEXXY, BIJUVA, or ANNOVERA, if such commercialization is delayed, or if the continued impact of the
COVID-19
pandemic on our business is worse than we anticipate, among other circumstances, we may consume funds significantly faster than we currently anticipate and our existing cash reserves would be insufficient to maintain compliance with the Financing Agreement covenants or satisfy our liquidity requirements until we are able to successfully commercialize IMVEXXY, BIJUVA, and ANNOVERA.
The Financing Agreement also requires us to maintain certain minimum quarterly product net revenue requirements and several other restrictive covenants. These and other terms in the Financing Agreement have to be monitored closely for compliance and could restrict our ability to grow our business or enter into transactions that we believe would be beneficial to our business. If we are unable to maintain the minimum unrestricted cash balance, achieve any of the total minimum net revenue requirements or otherwise comply with any other covenant of the Financing Agreement, all or a portion of our obligations under the Financing Agreement may be declared immediately due and payable, which would have an adverse effect on our business, results of operations and financial condition.
Risks and uncertainties related to
COVID-19.
We continue to be subject to risks and uncertainties in connection with the
COVID-19
pandemic. The extent of the future impact of the
COVID-19
pandemic on our business continues to be highly uncertain and difficult to predict. We continue to provide an uninterrupted supply of our portfolio of products for patients. We believe we have sufficient inventory of finished products to meet anticipated demand in the near future. Additionally, we believe we have sufficient active pharmaceutical ingredients on hand for the continued manufacture of our products. For additional information, see the discussion of our risks and uncertainties related to
COVID-19
in Note 1, Basis of presentation and summary of significant accounting policies in Item 1, Financial Statements, appearing elsewhere in this
10-Q
Report, and in our 2020 10-K Report.