the active phase 4 study , a pilot , open-label , single-arm study , aims to evaluate the effect of oxbryta on exercise capacity , as measured by cardiopulmonary exercise testing ( cpet ) in patients 12 years of age and older with scd . we also expect to conduct additional clinical studies of oxbryta , including to seek to expand the potential approved product label into younger pediatric populations as well as to study further the efficacy and safety profile of oxbryta for scd patients . in january 2021 , the european medicines agency , or ema , accepted for review our marketing authorization application , or maa , seeking full marketing authorization of oxbryta to treat hemolytic anemia 95 ( which is low hemoglobin due to red blood cell destruction ) in scd patients ages 12 years and older , and the maa is undergoing standard review by the ema . in addition , we plan to submit by mid-2021 a supplemental new drug application , or snda , to expand the current oxbryta label to include treatment of scd in children ages 4 to 11 years , under the fda 's accelerated approval pathway . thereafter , we also plan to submit a new drug application , or nda , for a new age-appropriate formulation for this patient population . to provide early access prior to potentially receiving additional marketing approval , we have established an expanded access protocol for eligible scd patients in the united states and an early access program for eligible scd patients for outside the united states . in addition , we have entered into an exclusive agreement with biopharma-middle east and africa , or biopharma-mea , to distribute oxbryta in the six countries that make up the gcc region ( bahrain , kuwait , oman , qatar , saudi arabia , and the united arab emirates ) , where the u.s. approval of oxbryta can be referenced to allow for access to the medicine while health authorities conduct their reviews . beyond oxbryta , we are engaged in other research and development activities , including working on new targets to potentially develop next generation of treatments for scd , including inclacumab , a p-selectin inhibitor , which is a clinically validated target in scd , known to reduce the incidence of vaso-occlusive crises , or vocs , and our next generation hemoglobin polymerization inhibitor , gbt021601 , or gbt601 . as part of our efforts to build our pipeline , we regularly evaluate opportunities to in-license , acquire or invest in new business , technology or assets or engage in related discussions with other business entities . we licensed inclacumab from f. hoffmann-la roche ltd. and hoffmann-la roche inc. ( together , “ roche ” ) under the license agreement we entered into in august 2018 , or roche agreement . prior to licensing inclacumab to us , roche conducted clinical studies that enrolled more than 700 non-scd patients and demonstrated an encouraging pharmacokinetic , safety , and tolerability profile for inclacumab . we expect to be able to leverage the safety data from roche 's prior clinical studies , as we proceed with our development of inclacumab as a potential treatment to reduce the frequency of vocs in patients with scd and to reduce the hospital voc readmission rate for patients that require inpatient treatment for an initial voc episode . we expect to initiate two pivotal clinical trials by the end of the first half of 2021. one study will be a chronic prevention study with an endpoint of the reduction in vocs over a 48-week treatment period , and the other study will focus on hospital readmissions with an endpoint of the reduction of the rate of readmission to hospitals for voc within 90 days following an initial hospitalization for voc . while still in early stages , we have an ongoing collaboration with syros pharmaceuticals , inc. , or syros , which we entered into with a license and collaboration agreement , or syros agreement , in december 2019 , to discover , develop and commercialize novel therapies for scd and beta thalassemia . we are currently exploring orally available , small molecule drugs designed to upregulate fetal hemoglobin . under the syros agreement , we have an option to obtain an exclusive worldwide license to develop , manufacture and commercialize any compounds or products resulting from the collaboration , subject to syros ' option to co-promote the first product in the united states . in march 2020 , the centers for disease control and prevention , or cdc , declared a global pandemic related to sars-cov-2 , the virus that causes coronavirus disease 2019 , or covid-19 , and the pandemic has impacted our business , including our commercialization of oxbryta and our research and development activities . for example , we implemented a temporary work from home policy ; temporarily suspended our field team from most in-person interactions , including visits to physician offices , clinics and hospitals as well as in-person meetings with payors ; and temporarily delayed or paused certain research and development activities , including screening and enrollment in all clinical studies sponsored by us . as we continue to monitor and work toward resumption of all trial activities , we are continuing with administrative trial-start up activities ( such as contracting and irb/ec approvals ) . notably , the covid-19 pandemic has not significantly impacted our supply of oxbryta . we continue to believe we have an adequate supply of oxbryta to sustain estimated patient need through 2021 , and we are continuing to produce oxbryta tablets . 96 we have seen a significant decrease in weekly new patient prescriptions for oxbryta from a peak in early march , and we expect the rate of new patient prescriptions may remain lower depending on the course of the pandemic . story_separator_special_tag the process of conducting the necessary clinical research to obtain regulatory approval is costly and time-consuming , and research and development is highly uncertain . as a result , we are unable to determine the duration and completion costs of our research and development projects or when and to what extent we will generate revenue from the commercialization and sale of any of our product candidates . the following table summarizes our research and development expenses incurred during the respective periods ( in thousands , except percentages ) : replace_table_token_6_th * change is not meaningful research and development expenses decreased by $ 19.4 million , or 11 % , to $ 155.1 million for the year ended december 31 , 2020 from $ 174.6 million for the year ended december 31 , 2019. the decrease was primarily due to a $ 33.9 million decrease in external costs for oxbryta related to manufacturing costs and medical affairs costs that were previously expensed to research and development prior to approval by the fda and a $ 1.7 million decrease in other preclinical programs . the decrease was partially offset by a $ 16.3 million increase in external costs associated with inclacumab driven by the manufacturing activities . stock-based compensation expense related to research and development was $ 18.1 million for the year ended december 31 , 2020 and $ 19.1 million for the year ended december 31 , 2019. the increase was primarily due to hiring additional personnel and stock price appreciation . 102 selling , general and administrative expenses selling , general and administrative expenses consist primarily of costs incurred in our executive , commercial , finance , corporate development , human resource , information technology , legal , compliance and other general and administrative functions , which include : employee-related expenses , which include salaries , benefits and stock-based compensation ; fees to third-party vendors providing customer support services ; expenses incurred under agreements with consultants ; and facilities and other allocated expenses , which include expenses for rent and maintenance of facilities , depreciation and amortization expense and other supplies . we expense all selling , general and administrative costs in the periods in which they are incurred . we expect our general and administrative expenses to continue to grow as we progress through this early stage of the commercialization of oxbryta . general and administrative expenses increased by $ 93.8 million , or 80 % , to $ 210.9 million for the year ended december 31 , 2020 from $ 117.1 million for the year ended december 31 , 2019. the increase was primarily due to an increase of $ 32.9 million in salary and benefit costs due to a greater number of employees , a $ 26.9 million increase in stock-based compensation expense as a result of our hiring additional personnel and stock price appreciation , a $ 26.0 million increase in professional and consulting services due to the growth of our operations and the commercialization of oxbryta , and an $ 8.0 million increase in other general and administrative expense due to the growth of our operations , such as higher rent expenses resulting from our move into the new facility . selling , general and administrative related stock-based compensation expense was $ 53.4 million and $ 26.5 million for the year ended december 31 , 2020 and 2019 , respectively . gain on lease modification gain on lease modification of $ 1.0 million and $ 8.3 million for the year ended december 31 , 2020 and 2019 , respectively , was related to the lease amendment of our previous premises located in south san francisco , california for 67,185 square feet of space in october 2019. interest income interest income was $ 5.8 million in 2020 compared to interest income of $ 15.6 million in 2019. the $ 9.8 million decrease was primarily due to decrease in interest income from our investment balances . interest expenses interest expense was $ 9.8 million in 2020 compared to interest expense of $ 0.9 million in 2019. the $ 8.9 million increase was primarily due to higher interest expense related to our term loan entered in december 2019. income taxes as of december 31 , 2020 , we had federal net operating loss carryforwards of approximately $ 829.1 million to offset future federal taxable income , with $ 209.9 million available through 2037 and $ 619.2 million available indefinitely . we also had state net operating loss carryforwards of approximately $ 587.1 million that may offset future state taxable income , through 2040. current federal and state tax laws include substantial restrictions on the utilization of net operating losses and tax credits in the event of an ownership change . even if the carryforwards are available , they may be subject to annual limitations , lack of future taxable income , or future 103 ownership changes that could result in the expiration of the carryforwards before they are utilized . at december 31 , 2020 , we recorded a 100 % valuation allowance against our deferred tax assets of approximately $ 325.7 million , as at that time our management believed it was uncertain that they would be fully realized . if we determine in the future that we will be able to realize all or a portion of our net operating loss carryforwards , an adjustment to our net operating loss carryforwards would increase net income in the period in which we make such a determination . for the years ended december 31 , 2019 and 2018 the comparison of the fiscal years ended december 31 , 2019 and 2018 can be found in our annual report on form 10-k for the fiscal year ended december 31 , 2019 located within part ii , item 7. management 's discussion and analysis of financial condition and results of operations , which is incorporated herein by reference . liquidity and capital resources we are not profitable and have incurred

cash flows from operating activities net cash used in operating activities for the year ended december 31 , 2020 was $ 211.9 million , consisting of a net loss of $ 247.6 million , which was partially offset by non-cash charges of $ 71.5 million for stock-based compensation and $ 12.5 million for net depreciation and amortization expense . the change in our net operating assets and liabilities was due primarily to an increase of $ 36.8 million in inventories to support our current and anticipated oxbryta commercial sales , an increase in accounts receivable of $ 14.9 million due to higher oxbryta commercial sales , a decrease of $ 10.1 million in accrued liabilities primarily due to the payout of the accrued $ 20.0 million upfront payment to syros in january 2020 and timing of manufacturing activities offset by higher sales and allowance accrual due to higher oxbryta commercial sales , an increase of $ 8.4 million in accounts payable due to timing of payments , and an increase of $ 6.4 million in accrued compensation related to higher number of employees . net cash used in operating activities was $ 194.4 million for the year ended december 31 , 2019 , consisting of a net loss of $ 266.8 million , which was partially offset by non-cash charges of $ 45.7 million for stock-based compensation , $ 8.3 million for gain on lease modification and $ 7.9 million for depreciation and amortization expense .


 Write a concise suspicious activity report of the following text delimited by triple backquotes. Return your response as a formal report which covers the key points highlighting the location,dates,entity names and account holder information in chronological order of the text.
     ```cash flows from operating activities net cash used in operating activities for the year ended december 31 , 2020 was $ 211.9 million , consisting of a net loss of $ 247.6 million , which was partially offset by non-cash charges of $ 71.5 million for stock-based compensation and $ 12.5 million for net depreciation and amortization expense . the change in our net operating assets and liabilities was due primarily to an increase of $ 36.8 million in inventories to support our current and anticipated oxbryta commercial sales , an increase in accounts receivable of $ 14.9 million due to higher oxbryta commercial sales , a decrease of $ 10.1 million in accrued liabilities primarily due to the payout of the accrued $ 20.0 million upfront payment to syros in january 2020 and timing of manufacturing activities offset by higher sales and allowance accrual due to higher oxbryta commercial sales , an increase of $ 8.4 million in accounts payable due to timing of payments , and an increase of $ 6.4 million in accrued compensation related to higher number of employees . net cash used in operating activities was $ 194.4 million for the year ended december 31 , 2019 , consisting of a net loss of $ 266.8 million , which was partially offset by non-cash charges of $ 45.7 million for stock-based compensation , $ 8.3 million for gain on lease modification and $ 7.9 million for depreciation and amortization expense .
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 Suspicious Activity Report : the active phase 4 study , a pilot , open-label , single-arm study , aims to evaluate the effect of oxbryta on exercise capacity , as measured by cardiopulmonary exercise testing ( cpet ) in patients 12 years of age and older with scd . we also expect to conduct additional clinical studies of oxbryta , including to seek to expand the potential approved product label into younger pediatric populations as well as to study further the efficacy and safety profile of oxbryta for scd patients . in january 2021 , the european medicines agency , or ema , accepted for review our marketing authorization application , or maa , seeking full marketing authorization of oxbryta to treat hemolytic anemia 95 ( which is low hemoglobin due to red blood cell destruction ) in scd patients ages 12 years and older , and the maa is undergoing standard review by the ema . in addition , we plan to submit by mid-2021 a supplemental new drug application , or snda , to expand the current oxbryta label to include treatment of scd in children ages 4 to 11 years , under the fda 's accelerated approval pathway . thereafter , we also plan to submit a new drug application , or nda , for a new age-appropriate formulation for this patient population . to provide early access prior to potentially receiving additional marketing approval , we have established an expanded access protocol for eligible scd patients in the united states and an early access program for eligible scd patients for outside the united states . in addition , we have entered into an exclusive agreement with biopharma-middle east and africa , or biopharma-mea , to distribute oxbryta in the six countries that make up the gcc region ( bahrain , kuwait , oman , qatar , saudi arabia , and the united arab emirates ) , where the u.s. approval of oxbryta can be referenced to allow for access to the medicine while health authorities conduct their reviews . beyond oxbryta , we are engaged in other research and development activities , including working on new targets to potentially develop next generation of treatments for scd , including inclacumab , a p-selectin inhibitor , which is a clinically validated target in scd , known to reduce the incidence of vaso-occlusive crises , or vocs , and our next generation hemoglobin polymerization inhibitor , gbt021601 , or gbt601 . as part of our efforts to build our pipeline , we regularly evaluate opportunities to in-license , acquire or invest in new business , technology or assets or engage in related discussions with other business entities . we licensed inclacumab from f. hoffmann-la roche ltd. and hoffmann-la roche inc. ( together , “ roche ” ) under the license agreement we entered into in august 2018 , or roche agreement . prior to licensing inclacumab to us , roche conducted clinical studies that enrolled more than 700 non-scd patients and demonstrated an encouraging pharmacokinetic , safety , and tolerability profile for inclacumab . we expect to be able to leverage the safety data from roche 's prior clinical studies , as we proceed with our development of inclacumab as a potential treatment to reduce the frequency of vocs in patients with scd and to reduce the hospital voc readmission rate for patients that require inpatient treatment for an initial voc episode . we expect to initiate two pivotal clinical trials by the end of the first half of 2021. one study will be a chronic prevention study with an endpoint of the reduction in vocs over a 48-week treatment period , and the other study will focus on hospital readmissions with an endpoint of the reduction of the rate of readmission to hospitals for voc within 90 days following an initial hospitalization for voc . while still in early stages , we have an ongoing collaboration with syros pharmaceuticals , inc. , or syros , which we entered into with a license and collaboration agreement , or syros agreement , in december 2019 , to discover , develop and commercialize novel therapies for scd and beta thalassemia . we are currently exploring orally available , small molecule drugs designed to upregulate fetal hemoglobin . under the syros agreement , we have an option to obtain an exclusive worldwide license to develop , manufacture and commercialize any compounds or products resulting from the collaboration , subject to syros ' option to co-promote the first product in the united states . in march 2020 , the centers for disease control and prevention , or cdc , declared a global pandemic related to sars-cov-2 , the virus that causes coronavirus disease 2019 , or covid-19 , and the pandemic has impacted our business , including our commercialization of oxbryta and our research and development activities . for example , we implemented a temporary work from home policy ; temporarily suspended our field team from most in-person interactions , including visits to physician offices , clinics and hospitals as well as in-person meetings with payors ; and temporarily delayed or paused certain research and development activities , including screening and enrollment in all clinical studies sponsored by us . as we continue to monitor and work toward resumption of all trial activities , we are continuing with administrative trial-start up activities ( such as contracting and irb/ec approvals ) . notably , the covid-19 pandemic has not significantly impacted our supply of oxbryta . we continue to believe we have an adequate supply of oxbryta to sustain estimated patient need through 2021 , and we are continuing to produce oxbryta tablets . 96 we have seen a significant decrease in weekly new patient prescriptions for oxbryta from a peak in early march , and we expect the rate of new patient prescriptions may remain lower depending on the course of the pandemic . story_separator_special_tag the process of conducting the necessary clinical research to obtain regulatory approval is costly and time-consuming , and research and development is highly uncertain . as a result , we are unable to determine the duration and completion costs of our research and development projects or when and to what extent we will generate revenue from the commercialization and sale of any of our product candidates . the following table summarizes our research and development expenses incurred during the respective periods ( in thousands , except percentages ) : replace_table_token_6_th * change is not meaningful research and development expenses decreased by $ 19.4 million , or 11 % , to $ 155.1 million for the year ended december 31 , 2020 from $ 174.6 million for the year ended december 31 , 2019. the decrease was primarily due to a $ 33.9 million decrease in external costs for oxbryta related to manufacturing costs and medical affairs costs that were previously expensed to research and development prior to approval by the fda and a $ 1.7 million decrease in other preclinical programs . the decrease was partially offset by a $ 16.3 million increase in external costs associated with inclacumab driven by the manufacturing activities . stock-based compensation expense related to research and development was $ 18.1 million for the year ended december 31 , 2020 and $ 19.1 million for the year ended december 31 , 2019. the increase was primarily due to hiring additional personnel and stock price appreciation . 102 selling , general and administrative expenses selling , general and administrative expenses consist primarily of costs incurred in our executive , commercial , finance , corporate development , human resource , information technology , legal , compliance and other general and administrative functions , which include : employee-related expenses , which include salaries , benefits and stock-based compensation ; fees to third-party vendors providing customer support services ; expenses incurred under agreements with consultants ; and facilities and other allocated expenses , which include expenses for rent and maintenance of facilities , depreciation and amortization expense and other supplies . we expense all selling , general and administrative costs in the periods in which they are incurred . we expect our general and administrative expenses to continue to grow as we progress through this early stage of the commercialization of oxbryta . general and administrative expenses increased by $ 93.8 million , or 80 % , to $ 210.9 million for the year ended december 31 , 2020 from $ 117.1 million for the year ended december 31 , 2019. the increase was primarily due to an increase of $ 32.9 million in salary and benefit costs due to a greater number of employees , a $ 26.9 million increase in stock-based compensation expense as a result of our hiring additional personnel and stock price appreciation , a $ 26.0 million increase in professional and consulting services due to the growth of our operations and the commercialization of oxbryta , and an $ 8.0 million increase in other general and administrative expense due to the growth of our operations , such as higher rent expenses resulting from our move into the new facility . selling , general and administrative related stock-based compensation expense was $ 53.4 million and $ 26.5 million for the year ended december 31 , 2020 and 2019 , respectively . gain on lease modification gain on lease modification of $ 1.0 million and $ 8.3 million for the year ended december 31 , 2020 and 2019 , respectively , was related to the lease amendment of our previous premises located in south san francisco , california for 67,185 square feet of space in october 2019. interest income interest income was $ 5.8 million in 2020 compared to interest income of $ 15.6 million in 2019. the $ 9.8 million decrease was primarily due to decrease in interest income from our investment balances . interest expenses interest expense was $ 9.8 million in 2020 compared to interest expense of $ 0.9 million in 2019. the $ 8.9 million increase was primarily due to higher interest expense related to our term loan entered in december 2019. income taxes as of december 31 , 2020 , we had federal net operating loss carryforwards of approximately $ 829.1 million to offset future federal taxable income , with $ 209.9 million available through 2037 and $ 619.2 million available indefinitely . we also had state net operating loss carryforwards of approximately $ 587.1 million that may offset future state taxable income , through 2040. current federal and state tax laws include substantial restrictions on the utilization of net operating losses and tax credits in the event of an ownership change . even if the carryforwards are available , they may be subject to annual limitations , lack of future taxable income , or future 103 ownership changes that could result in the expiration of the carryforwards before they are utilized . at december 31 , 2020 , we recorded a 100 % valuation allowance against our deferred tax assets of approximately $ 325.7 million , as at that time our management believed it was uncertain that they would be fully realized . if we determine in the future that we will be able to realize all or a portion of our net operating loss carryforwards , an adjustment to our net operating loss carryforwards would increase net income in the period in which we make such a determination . for the years ended december 31 , 2019 and 2018 the comparison of the fiscal years ended december 31 , 2019 and 2018 can be found in our annual report on form 10-k for the fiscal year ended december 31 , 2019 located within part ii , item 7. management 's discussion and analysis of financial condition and results of operations , which is incorporated herein by reference . liquidity and capital resources we are not profitable and have incurred

