this chart provides guidance to hcps and patients as to which options exist , and to payers ( including pharmacy benefit managers ) as to which methods they need to cover . in june 2020 , medi-span and first databank , two major drug information databases that payers consult for pricing and product information , granted phexxi a new classification in their databases and pricing compendia as the first and only “ vaginal ph modulator . ” we believe that a new category of contraception should be established for vaginal ph modulators such as phexxi to reflect this unique mechanism of action , and are working with the office of women 's health under the health resources and services administration to have the birth control chart updated accordingly . phexxi 's listing with medi-span and first databank , coupled with our timely response to payer clinical requests and our clinical presentation , enabled us to achieve coverage for 55 % of commercial lives at launch in september 2020. as of february 2021 , we have coverage for approximately 55.1 % of u.s. commercial lives , including approximately 8 million lives covered at no out-of-pocket cost and approximately 13.7 million lives covered under our december 2020 contract award from the u.s. department of veterans affairs . we continue to work to increase the number of lives covered . 74 additionally , on january 1 , 2021 , the u.s. medicaid population gained access to phexxi through evofem 's participation in the centers for disease control and prevention 's ( cdc ) medicaid national drug rebate program . medicaid provides health coverage to approximately 68 million members . we continue to monitor various non-financial metrics that we believe may be relevant in assessing our commercialization strategies for phexxi . these metrics include unit shipments from our warehouse to wholesale distributors , our wholesale distributors ' shipments to retail pharmacies , the number of hcps prescribing phexxi , the number of phexxi prescriptions and an increase in overall awareness of phexxi measured by monthly surveys conducted by an independent third-party research group among women at risk for pregnancy . available prescription data as of and through the week of february 12 , 2021 , indicates that more than 2,650 unique hcps have prescribed phexxi since its commercial launch , with approximately 4,250 prescriptions for the year ended december 31 , 2020 and approximately 2,900 prescriptions from january 1 , 2021 through february 12 , 2021. from commercial launch in september 2020 through january 2021 , monthly prescriptions for phexxi and the number of hcps prescribing phexxi have increased by an average of approximately 58 % and 50 % , respectively , on a monthly basis . additionally , during the year ended december 31 , 2020 and from january 1 , 2021 through february 26 , 2021 , approximately 6,350 and 6,430 units , respectively , were distributed by wholesalers to retail pharmacies . from february 1 , 2021 through february 26 , 2021 , we sold approximately 3,800 units of phexxi , our highest monthly sales figure since launch . evo100 : our sti preventive product candidate our lead product candidate , evo100 , is an antimicrobial vaginal gel under evaluation for the prevention of chlamydia and gonorrhea in women - two of the most pervasive stis in the united states . currently , there are no fda‑approved prescription products for the prevention of either of these commonly reported sexually transmitted infections ( stis ) . in december 2019 , we reported positive top-line results from our clinical trial amprevence . the trial enrolled 860 women at 50 sites in the united states for a four-month intervention period followed by a one-month follow-up period . amprevence met both its primary and secondary endpoints of reducing the risk of chlamydia and gonorrhea infection , respectively . in this landmark trial , the infection rate of chlamydia among women who used evo100 for the four-month study period was 4.9 % ( n=14/288 ) compared to 9.8 % among those who used placebo for four months ( n=28/287 ) ( p=0.024 ) , a relative risk reduction of 50 % in the primary endpoint . among the reported cases of gonorrhea infection , the infection rate was 0.7 % in the evo100 arm ( n=2/280 ) , compared to 3.2 % in the placebo arm ( n=9/277 ) ( p=0.03 ) , a relative risk reduction of 78 % in the secondary endpoint . the study further demonstrated that evo100 was generally safe and well tolerated . the number of adverse events was similar across both arms ( 7.2 % for evo100 and 7.5 % for placebo ) and no serious treatment-related adverse events were reported . in october 2020 , we initiated the phase 3 evoguard clinical trial . this randomized , placebo-controlled pivotal trial is designed to enroll 1,730 women with a prior chlamydia or gonorrhea infection and who are at risk for future infection . participants are enrolled for a 16-week interventional phase followed by a one-month follow-up period . we expect to complete enrollment in the fourth quarter of 2021 , and to report top-line evoguard results in mid-2022 . according to the cdc , any sexually active person can be infected with chlamydia and or gonorrhea , and many are asymptomatic . despite the cdc recommendation for condom use to prevent stis , u.s. rates of infection with chlamydia and gonorrhea climbed in 2018 for the fifth consecutive year . based on these reports , an estimated 78 million women 18-65 years of age who are sexually active in the united states could be at a risk for one of these stis . in december 2020 , the cdc updated its treatment guidelines for gonorrhea infections due to data demonstrating increasing resistance to the antibiotic azithromycin . the need for expanded preventive measures is clear . story_separator_special_tag the fair value of the baker notes issued , and the change in fair value of the baker notes at the reporting date , were determined using a monte carlo simulation-based model . monte carlo simulation was used to take into account several embedded features and factors including the future value of our common stock , a potential change of control event , the maturity term of the baker notes , the probability of an event of voluntary conversion of the baker notes , exercise of the put right , and exercise of our call right . fair value of stock options and warrants 79 the fair value of stock options and warrants issued in various financing transactions in connection with the merger and post- merger , the change in fair value of warrants as a result of modifications to these instruments , and mark-to-market adjustments for liability classified warrants were determined using the black-scholes option-pricing model based on the applicable assumptions , which include the exercise price of these options and warrants , time to expiration , expected volatility of our peer group of companies , risk-free interest rate and expected dividend . fair value of purchase rights the fair value of the rights granted to the purchasers to optionally purchase from the company up to $ 10.0 million of baker notes ( the baker purchase rights ) at the purchasers ' discretion at any time prior to the company receiving at least $ 100.0 million in aggregate gross proceeds from one or more sales of equity securities issued in connection with the baker bros. purchase agreement , as described in note 5- convertible notes , and the change in fair value of baker purchase rights upon exercise of such rights , was determined as the maximum of ( i ) the fair value of rights to purchase the additional $ 10.0 million baker notes and ; ( ii ) the fair value of the shares of on as-if converted basis , which was determined by the lattice model . the fair value of rights to purchase the accompanying 2,049,180 baker warrants ( as defined below ) was valued using a geske option-pricing model . the geske model was based on the applicable assumptions , including the underlying stock price , warrant exercise price , the exercise price of the rights to purchase the baker warrants , the term of the baker warrants , the term of the rights to purchase the baker warrants , expected volatility of the company 's peer group , risk-free interest rate and expected dividend . the fair value of the rights provided to the 2019 purchasers ( as defined below ) to optionally purchase from the company to issue and sell to each 2019 purchaser the shares of common stock and warrants as specified in the securities purchase agreement , dated april 10 , 2019 , with pdl biopharma , inc. , a delaware corporation ( pdl ) , funds discretionally managed by invesco ltd. ( invesco ) and funds managed by woodford investment management ltd. ( wim , collectively with invesco and pdl , the 2019 purchasers ) during the period beginning on april 11 , 2019 and ending on june 10 , 2019 ( the private placement purchase rights ) , and the change in fair value of the private placement purchase rights on june 5 , 2019 , was determined using a combination of a lattice model and black-scholes option-pricing model . the lattice model was used to determine the future value of our common stock . the black-scholes option-pricing model was based on the applicable assumptions , including the future value of the company 's common stock as determined by the lattice model , warrant exercise price , time to expiration , expected volatility of our peer group , risk-free interest rate and expected dividend . inventories inventories , consisting of purchased materials , direct labor and manufacturing overheads , are stated at the lower of cost , or net realizable value . cost is determined on a first-in , first-out basis . net realizable value is the estimated selling price in the ordinary course of business , less reasonably predictable costs of completion , disposal , and transportation . at each balance sheet date , we evaluate ending inventories for excess quantities , obsolescence , or shelf-life expiration . the evaluation includes an analysis of our current and future strategic plans , anticipated future sales , the price projections of future demand , and the remaining shelf life of goods on han d. to the extent that we determine there are excess or obsolete inventory or quantities with a shelf life that is too near its expiration for us to reasonably expect that it can sell those products prior to their expiration , we adjust the carrying value to estimated net realizable value . results of operations year ended december 31 , 2020 compared to year ended december 31 , 2019 ( in thousands ) : net product sales replace_table_token_2_th phexxi was approved in may 2020 , and commercially launched in september 2020. net product sales were $ 0.4 million for the year ended december 31 , 2020 . 80 cost of goods sold replace_table_token_3_th cost of goods sold was $ 0.5 million for the year ended december 31 , 2020 , which includes a $ 0.1 million one-time charge related to product labelling rework recorded as scrap costs . research and development expenses replace_table_token_4_th the overall decrease in research and development expenses was due to a $ 3.7 million reduction in outside services associated with the phexxi new drug application for the prevention of pregnancy that was resubmitted to the fda in the fourth quarter of 2019 and a $ 3.5 million reduction in clinical trial costs associated with the completion of the clinical phases of ampower and amprevence in december 2018 and 2019 , respectively . these aggregated decreases are partially offset by a $ 0.8

cash flows from operating activities . during the year ended december 2020 and 2019 , the primary use of cash , cash equivalents and restricted cash has been to fund development and commercialization of our lead product , phexxi , and to support selling and marketing , and general and administrative operations . cash flows from investing activities . during the year ended december 2020 , the change in net cash , cash equivalents and restricted cash provided by investing activities was primarily due to an $ 8.2 million cash inflow from maturities of short-term investments offset by $ 2.3 million in purchases of property and equipment . net cash , cash equivalents and restricted cash used in investing activities for the year ended december 2019 was primarily the purchase of short-term investments of $ 8.2 million . 83 cash flows from financing activities . during the year ended december 2020 , the primary source of cash , cash equivalents and restricted cash was provided from the sale of an aggregate of 31,700,000 shares of common stock for net proceeds of approximately $ 103.7 million , net of underwriting commissions , gross proceeds of $ 50.0 million from issuance of convertible notes and warrants , the sale of 676,656 shares of common stock under the at-the-market program for net proceeds of approximately $ 3.8 million in cash and cash equivalents ( including $ 0.3 million that was included in otherreceivables in the consolidated balance sheet at december 31 , 2019 ) , net of commissions , and the issuance of 150,353 shares of our common stock under the 2019 employee stock purchase plan ( espp ) and exercise of stock options with aggregate proceeds of $ 0.4 million .


 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 . during the year ended december 2020 and 2019 , the primary use of cash , cash equivalents and restricted cash has been to fund development and commercialization of our lead product , phexxi , and to support selling and marketing , and general and administrative operations . cash flows from investing activities . during the year ended december 2020 , the change in net cash , cash equivalents and restricted cash provided by investing activities was primarily due to an $ 8.2 million cash inflow from maturities of short-term investments offset by $ 2.3 million in purchases of property and equipment . net cash , cash equivalents and restricted cash used in investing activities for the year ended december 2019 was primarily the purchase of short-term investments of $ 8.2 million . 83 cash flows from financing activities . during the year ended december 2020 , the primary source of cash , cash equivalents and restricted cash was provided from the sale of an aggregate of 31,700,000 shares of common stock for net proceeds of approximately $ 103.7 million , net of underwriting commissions , gross proceeds of $ 50.0 million from issuance of convertible notes and warrants , the sale of 676,656 shares of common stock under the at-the-market program for net proceeds of approximately $ 3.8 million in cash and cash equivalents ( including $ 0.3 million that was included in otherreceivables in the consolidated balance sheet at december 31 , 2019 ) , net of commissions , and the issuance of 150,353 shares of our common stock under the 2019 employee stock purchase plan ( espp ) and exercise of stock options with aggregate proceeds of $ 0.4 million .
```    
 Suspicious Activity Report : this chart provides guidance to hcps and patients as to which options exist , and to payers ( including pharmacy benefit managers ) as to which methods they need to cover . in june 2020 , medi-span and first databank , two major drug information databases that payers consult for pricing and product information , granted phexxi a new classification in their databases and pricing compendia as the first and only “ vaginal ph modulator . ” we believe that a new category of contraception should be established for vaginal ph modulators such as phexxi to reflect this unique mechanism of action , and are working with the office of women 's health under the health resources and services administration to have the birth control chart updated accordingly . phexxi 's listing with medi-span and first databank , coupled with our timely response to payer clinical requests and our clinical presentation , enabled us to achieve coverage for 55 % of commercial lives at launch in september 2020. as of february 2021 , we have coverage for approximately 55.1 % of u.s. commercial lives , including approximately 8 million lives covered at no out-of-pocket cost and approximately 13.7 million lives covered under our december 2020 contract award from the u.s. department of veterans affairs . we continue to work to increase the number of lives covered . 74 additionally , on january 1 , 2021 , the u.s. medicaid population gained access to phexxi through evofem 's participation in the centers for disease control and prevention 's ( cdc ) medicaid national drug rebate program . medicaid provides health coverage to approximately 68 million members . we continue to monitor various non-financial metrics that we believe may be relevant in assessing our commercialization strategies for phexxi . these metrics include unit shipments from our warehouse to wholesale distributors , our wholesale distributors ' shipments to retail pharmacies , the number of hcps prescribing phexxi , the number of phexxi prescriptions and an increase in overall awareness of phexxi measured by monthly surveys conducted by an independent third-party research group among women at risk for pregnancy . available prescription data as of and through the week of february 12 , 2021 , indicates that more than 2,650 unique hcps have prescribed phexxi since its commercial launch , with approximately 4,250 prescriptions for the year ended december 31 , 2020 and approximately 2,900 prescriptions from january 1 , 2021 through february 12 , 2021. from commercial launch in september 2020 through january 2021 , monthly prescriptions for phexxi and the number of hcps prescribing phexxi have increased by an average of approximately 58 % and 50 % , respectively , on a monthly basis . additionally , during the year ended december 31 , 2020 and from january 1 , 2021 through february 26 , 2021 , approximately 6,350 and 6,430 units , respectively , were distributed by wholesalers to retail pharmacies . from february 1 , 2021 through february 26 , 2021 , we sold approximately 3,800 units of phexxi , our highest monthly sales figure since launch . evo100 : our sti preventive product candidate our lead product candidate , evo100 , is an antimicrobial vaginal gel under evaluation for the prevention of chlamydia and gonorrhea in women - two of the most pervasive stis in the united states . currently , there are no fda‑approved prescription products for the prevention of either of these commonly reported sexually transmitted infections ( stis ) . in december 2019 , we reported positive top-line results from our clinical trial amprevence . the trial enrolled 860 women at 50 sites in the united states for a four-month intervention period followed by a one-month follow-up period . amprevence met both its primary and secondary endpoints of reducing the risk of chlamydia and gonorrhea infection , respectively . in this landmark trial , the infection rate of chlamydia among women who used evo100 for the four-month study period was 4.9 % ( n=14/288 ) compared to 9.8 % among those who used placebo for four months ( n=28/287 ) ( p=0.024 ) , a relative risk reduction of 50 % in the primary endpoint . among the reported cases of gonorrhea infection , the infection rate was 0.7 % in the evo100 arm ( n=2/280 ) , compared to 3.2 % in the placebo arm ( n=9/277 ) ( p=0.03 ) , a relative risk reduction of 78 % in the secondary endpoint . the study further demonstrated that evo100 was generally safe and well tolerated . the number of adverse events was similar across both arms ( 7.2 % for evo100 and 7.5 % for placebo ) and no serious treatment-related adverse events were reported . in october 2020 , we initiated the phase 3 evoguard clinical trial . this randomized , placebo-controlled pivotal trial is designed to enroll 1,730 women with a prior chlamydia or gonorrhea infection and who are at risk for future infection . participants are enrolled for a 16-week interventional phase followed by a one-month follow-up period . we expect to complete enrollment in the fourth quarter of 2021 , and to report top-line evoguard results in mid-2022 . according to the cdc , any sexually active person can be infected with chlamydia and or gonorrhea , and many are asymptomatic . despite the cdc recommendation for condom use to prevent stis , u.s. rates of infection with chlamydia and gonorrhea climbed in 2018 for the fifth consecutive year . based on these reports , an estimated 78 million women 18-65 years of age who are sexually active in the united states could be at a risk for one of these stis . in december 2020 , the cdc updated its treatment guidelines for gonorrhea infections due to data demonstrating increasing resistance to the antibiotic azithromycin . the need for expanded preventive measures is clear . story_separator_special_tag the fair value of the baker notes issued , and the change in fair value of the baker notes at the reporting date , were determined using a monte carlo simulation-based model . monte carlo simulation was used to take into account several embedded features and factors including the future value of our common stock , a potential change of control event , the maturity term of the baker notes , the probability of an event of voluntary conversion of the baker notes , exercise of the put right , and exercise of our call right . fair value of stock options and warrants 79 the fair value of stock options and warrants issued in various financing transactions in connection with the merger and post- merger , the change in fair value of warrants as a result of modifications to these instruments , and mark-to-market adjustments for liability classified warrants were determined using the black-scholes option-pricing model based on the applicable assumptions , which include the exercise price of these options and warrants , time to expiration , expected volatility of our peer group of companies , risk-free interest rate and expected dividend . fair value of purchase rights the fair value of the rights granted to the purchasers to optionally purchase from the company up to $ 10.0 million of baker notes ( the baker purchase rights ) at the purchasers ' discretion at any time prior to the company receiving at least $ 100.0 million in aggregate gross proceeds from one or more sales of equity securities issued in connection with the baker bros. purchase agreement , as described in note 5- convertible notes , and the change in fair value of baker purchase rights upon exercise of such rights , was determined as the maximum of ( i ) the fair value of rights to purchase the additional $ 10.0 million baker notes and ; ( ii ) the fair value of the shares of on as-if converted basis , which was determined by the lattice model . the fair value of rights to purchase the accompanying 2,049,180 baker warrants ( as defined below ) was valued using a geske option-pricing model . the geske model was based on the applicable assumptions , including the underlying stock price , warrant exercise price , the exercise price of the rights to purchase the baker warrants , the term of the baker warrants , the term of the rights to purchase the baker warrants , expected volatility of the company 's peer group , risk-free interest rate and expected dividend . the fair value of the rights provided to the 2019 purchasers ( as defined below ) to optionally purchase from the company to issue and sell to each 2019 purchaser the shares of common stock and warrants as specified in the securities purchase agreement , dated april 10 , 2019 , with pdl biopharma , inc. , a delaware corporation ( pdl ) , funds discretionally managed by invesco ltd. ( invesco ) and funds managed by woodford investment management ltd. ( wim , collectively with invesco and pdl , the 2019 purchasers ) during the period beginning on april 11 , 2019 and ending on june 10 , 2019 ( the private placement purchase rights ) , and the change in fair value of the private placement purchase rights on june 5 , 2019 , was determined using a combination of a lattice model and black-scholes option-pricing model . the lattice model was used to determine the future value of our common stock . the black-scholes option-pricing model was based on the applicable assumptions , including the future value of the company 's common stock as determined by the lattice model , warrant exercise price , time to expiration , expected volatility of our peer group , risk-free interest rate and expected dividend . inventories inventories , consisting of purchased materials , direct labor and manufacturing overheads , are stated at the lower of cost , or net realizable value . cost is determined on a first-in , first-out basis . net realizable value is the estimated selling price in the ordinary course of business , less reasonably predictable costs of completion , disposal , and transportation . at each balance sheet date , we evaluate ending inventories for excess quantities , obsolescence , or shelf-life expiration . the evaluation includes an analysis of our current and future strategic plans , anticipated future sales , the price projections of future demand , and the remaining shelf life of goods on han d. to the extent that we determine there are excess or obsolete inventory or quantities with a shelf life that is too near its expiration for us to reasonably expect that it can sell those products prior to their expiration , we adjust the carrying value to estimated net realizable value . results of operations year ended december 31 , 2020 compared to year ended december 31 , 2019 ( in thousands ) : net product sales replace_table_token_2_th phexxi was approved in may 2020 , and commercially launched in september 2020. net product sales were $ 0.4 million for the year ended december 31 , 2020 . 80 cost of goods sold replace_table_token_3_th cost of goods sold was $ 0.5 million for the year ended december 31 , 2020 , which includes a $ 0.1 million one-time charge related to product labelling rework recorded as scrap costs . research and development expenses replace_table_token_4_th the overall decrease in research and development expenses was due to a $ 3.7 million reduction in outside services associated with the phexxi new drug application for the prevention of pregnancy that was resubmitted to the fda in the fourth quarter of 2019 and a $ 3.5 million reduction in clinical trial costs associated with the completion of the clinical phases of ampower and amprevence in december 2018 and 2019 , respectively . these aggregated decreases are partially offset by a $ 0.8

