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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
_________________________________________________________________________________
FORM 10-Q
_________________________________________________________________________________
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended June 30, 2021
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from              to            
Commission file number 1-4448
_________________________________________________________________________________
BAXTER INTERNATIONAL INC.
(Exact name of registrant as specified in its charter)
_________________________________________________________________________________
Delaware36-0781620
(State or other jurisdiction of
incorporation or organization)
(I.R.S. Employer
Identification No.)
One Baxter Parkway,Deerfield,Illinois60015
(Address of Principal Executive Offices)(Zip Code)
224.948.2000
(Registrant’s telephone number, including area code)
_________________________________________________________________________________
Securities registered pursuant to Section 12(b) of the Act:
Title of each classTrading Symbol(s)Name of each exchange on which registered
Common Stock, $1.00 par valueBAX (NYSE)New York Stock Exchange
Chicago Stock Exchange
0.4% Global Notes due 2024BAX 24New York Stock Exchange
1.3% Global Notes due 2025BAX 25New York Stock Exchange
1.3% Global Notes due 2029BAX 29New York Stock Exchange
3.95% Global Notes due 2030BAX 30New York Stock Exchange
1.73% Global Notes due 2031BAX 31New York Stock Exchange
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes x No o
Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T during the preceding 12 months (or for such shorter period that the registrant was required to submit such files). Yes x  No o
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act.
Large accelerated filerxAccelerated filero
Non-accelerated fileroSmaller reporting company
Emerging growth company
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.    o
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).     Yes    No x
The number of shares of the registrant’s Common Stock, par value $1.00 per share, outstanding as of July 22, 2021 was 499,910,255 shares.




BAXTER INTERNATIONAL INC.
FORM 10-Q
For the quarterly period ended June 30, 2021
TABLE OF CONTENTS
Page Number
Item 1A.






























PART I. FINANCIAL INFORMATION
Item 1.    Financial Statements
Baxter International Inc.
Condensed Consolidated Balance Sheets (unaudited)
(in millions, except share information)
June 30,
2021
December 31,
2020
Current assets:
Cash and cash equivalents $3,136 $3,730 
Accounts receivable, net of allowances of $117 in 2021 and $125 in 2020
2,021 2,007 
Inventories2,065 1,916 
Prepaid expenses and other current assets782 758 
Total current assets8,004 8,411 
Property, plant and equipment, net 4,649 4,722 
Goodwill 3,148 3,217 
Other intangible assets, net 1,910 1,671 
Operating lease right-of-use assets567 603 
Other non-current assets 1,404 1,395 
Total assets $19,682 $20,019 
Current liabilities:
Short-term debt $51 $ 
Current maturities of long-term debt and finance lease obligations406 406 
Accounts payable 1,005 1,043 
Accrued expenses and other current liabilities1,882 1,884 
Total current liabilities 3,344 3,333 
Long-term debt and finance lease obligations 5,710 5,786 
Operating lease liabilities469 501 
Other non-current liabilities 1,624 1,673 
Total liabilities 11,147 11,293 
Commitments and contingencies
Equity:
Common stock, $1 par value, authorized 2,000,000,000 shares, issued 683,494,944 shares in 2021 and 2020
683 683 
Common stock in treasury, at cost, 183,639,786 shares in 2021 and 178,580,208 shares in 2020
(11,561)(11,051)
Additional contributed capital6,090 6,043 
Retained earnings16,658 16,328 
Accumulated other comprehensive (loss) income(3,376)(3,314)
Total Baxter stockholders’ equity8,494 8,689 
Noncontrolling interests41 37 
Total equity8,535 8,726 
Total liabilities and equity$19,682 $20,019 
The accompanying notes are an integral part of these condensed consolidated financial statements.
2


Baxter International Inc.
Condensed Consolidated Statements of Income (unaudited)
(in millions, except per share data)
Three months ended
June 30,
Six months ended
June 30,
2021202020212020
Net sales$3,098 $2,718 $6,044 $5,520 
Cost of sales1,865 1,680 3,666 3,319 
Gross margin1,233 1,038 2,378 2,201 
Selling, general and administrative expenses675 590 1,302 1,218 
Research and development expenses139 117 267 263 
Other operating income, net(5) (5)(20)
Operating income424 331 814 740 
Interest expense, net34 36 68 57 
Other (income) expense, net(2)6 3 16 
Income before income taxes392 289 743 667 
Income tax expense 91 42 142 87 
Net income 301 247 601 580 
Net income attributable to noncontrolling interests3 1 5 2 
Net income attributable to Baxter stockholders$298 $246 $596 $578 
Earnings per share
Basic$0.59 $0.48 $1.18 $1.14 
Diluted$0.59 $0.48 $1.17 $1.12 
Weighted-average number of shares outstanding
Basic503 509 504 508 
Diluted509 517 510 517 
The accompanying notes are an integral part of these condensed consolidated financial statements.
3


Baxter International Inc.
Condensed Consolidated Statements of Comprehensive Income (unaudited)
(in millions)
Three months ended
June 30,
Six months ended
June 30,
2021202020212020
Net income$301 $247 $601 $580 
Other comprehensive income (loss), net of tax:
Currency translation adjustments, net of tax expense (benefit) of ($4) and $2 for the three months ended June 30, 2021 and 2020, respectively, and $13 and ($6) for the six months ended June 30, 2021 and 2020
88 189 (120)(170)
Pension and other postretirement benefits, net of tax expense of $3 and $1 for the three months ended June 30, 2021 and 2020, respectively, and $11 and $7 for the six months ended June 30, 2021 and 2020
11 4 41 26 
Hedging activities, net of tax expense (benefit) of $2 and $1 for the three months ended June 30, 2021 and 2020, respectively, and $5 and ($38) for the six months ended June 30, 2021 and 2020
5 (4)17 (134)
Total other comprehensive income (loss), net of tax104 189 (62)(278)
Comprehensive income405 436 539 302 
Less: Comprehensive income attributable to noncontrolling interests3 1 5 2 
Comprehensive income attributable to Baxter stockholders$402 $435 $534 $300 
The accompanying notes are an integral part of these condensed consolidated financial statements.
4


Baxter International Inc.
Condensed Consolidated Statements of Changes in Equity (unaudited)
(in millions)
For the three months ended June 30, 2021
Baxter International Inc. stockholders' equity
Common stock sharesCommon stockCommon stock shares
in treasury
Common stock in
treasury
Additional contributed capitalRetained earningsAccumulated other comprehensive
income (loss)
Total Baxter stockholders' equityNoncontrolling interestsTotal equity
Balance as of April 1, 2021683 $683 181 $(11,296)$6,043 $16,502 $(3,480)$8,452 $38 $8,490 
Net income— — — — — 298 — 298 3 301 
Other comprehensive income (loss)— — — — — — 104 104 — 104 
Purchases of treasury stock— — 3 (300)— — — (300)— (300)
Stock issued under employee benefit plans and other— —  35 47 — — 82 — 82 
Dividends declared on common stock— — — — — (142)— (142)— (142)
Balance as of June 30, 2021683 $683 184 $(11,561)$6,090 $16,658 $(3,376)$8,494 $41 $8,535 
For the six months ended June 30, 2021
Baxter International Inc. stockholders' equity
Common stock sharesCommon stockCommon stock shares in treasuryCommon stock in treasuryAdditional contributed capitalRetained earningsAccumulated other comprehensive income (loss)Total Baxter stockholders' equityNoncontrolling interestsTotal equity
Balance as of January 1, 2021683 $683 179 $(11,051)$6,043 $16,328 $(3,314)$8,689 $37 $8,726 
Net income— — — — — 596 — 596 5 601 
Other comprehensive income (loss)— — — — — — (62)(62)— (62)
Purchases of treasury stock— — 7 (600) — — (600)— (600)
Stock issued under employee benefit plans and other— — (2)90 47  — 137 — 137 
Dividends declared on common stock— — — — — (266)— (266)— (266)
Change in noncontrolling interests— — — — — — — — (1)(1)
Balance as of June 30, 2021683 $683 184 $(11,561)$6,090 $16,658 $(3,376)$8,494 $41 $8,535 

5


For the three months ended June 30, 2020
Baxter International Inc. stockholders' equity
Common stock sharesCommon stockCommon stock shares in treasuryCommon stock in treasuryAdditional contributed capitalRetained earningsAccumulated other comprehensive income (loss)Total Baxter stockholders' equityNoncontrolling interestsTotal equity
Balance as of April 1, 2020683 $683 175 $(10,677)$5,935 $15,935 $(4,177)$7,699 $31 $7,730 
Net income— — — — 246 — 246 1 247 
Other comprehensive income (loss)— — — — — — 189 189 — 189 
Stock issued under employee benefit plans and other— — (2)80 40 — — 120 — 120 
Dividends declared on common stock— — — — — (126)(126)— (126)
Balance as of June 30, 2020683 $683 173 $(10,597)$5,975 $16,055 $(3,988)$8,128 $32 $8,160 
For the six months ended June 30, 2020
Baxter International Inc. stockholders' equity
Common stock sharesCommon stockCommon stock shares in treasuryCommon stock in treasuryAdditional contributed capitalRetained earningsAccumulated other comprehensive income (loss)Total Baxter stockholders' equityNoncontrolling interestsTotal equity
Balance as of January 1, 2020683 $683 177 $(10,764)$5,955 $15,718 $(3,710)$7,882 $30 $7,912 
Adoption of new accounting standards— — — — — (4)— (4) (4)
Net income— — — — — 578 — 578 2 580 
Other comprehensive income (loss)— — — — — — (278)(278)— (278)
Stock issued under employee benefit plans and other— — (4)167 20 — — 187 — 187 
Dividends declared on common stock— — — — — (237)— (237)— (237)
Balance as of June 30, 2020683 $683 173 $(10,597)$5,975 $16,055 $(3,988)$8,128 $32 $8,160 
The accompanying notes are an integral part of these condensed consolidated financial statements.
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Baxter International Inc.
Condensed Consolidated Statements of Cash Flows (unaudited)
(in millions)
Six months ended
June 30,
20212020
Cash flows from operations
Net income$601 $580 
Adjustments to reconcile net income to cash flows from operations:
Depreciation and amortization439 401 
Deferred income taxes(36)(23)
Stock compensation59 64 
Net periodic pension and other postretirement costs51 40 
Intangible asset impairments 17 
Other10 27 
Changes in balance sheet items:
Accounts receivable, net(42)(14)
Inventories(155)(261)
Prepaid expenses and other current assets(24)(74)
Accounts payable (9)116 
Accrued expenses and other current liabilities(9)(164)
Other(31)(61)
Cash flows from operations – continuing operations854 648 
Cash flows from operations – discontinued operations (2)
Cash flows from operations854 646 
Cash flows from investing activities
Capital expenditures(329)(316)
Acquisitions, net of cash acquired, and investments(417)(453)
Other investing activities, net20 11 
Cash flows from investing activities(726)(758)
Cash flows from financing activities
Issuances of debt 1,240 
Net increase (decrease) in debt with original maturities of three months or less51 (225)
Cash dividends on common stock(249)(223)
Proceeds from stock issued under employee benefit plans93 151 
Purchases of treasury stock(565) 
Other financing activities, net(37)(34)
Cash flows from financing activities(707)909 
Effect of foreign exchange rate changes on cash, cash equivalents and restricted cash(17)(38)
Increase (decrease) in cash, cash equivalents and restricted cash(596)759 
Cash, cash equivalents and restricted cash at beginning of period3,736 3,335 
Cash, cash equivalents and restricted cash at end of period (1)
$3,140 $4,094 
(1)    We did not have any restricted cash balances as of December 31, 2019. The following table provides a reconciliation of cash, cash equivalents and restricted cash shown above to the amounts reported within the condensed consolidated balance sheet as of June 30, 2021,
December 31, 2020, and June 30, 2020 (in millions):
June 30, 2021December 31, 2020June 30, 2020
Cash and cash equivalents$3,136 $3,730 $4,085 
Restricted cash included in prepaid expenses and other current assets4 6 9 
Cash, cash equivalents and restricted cash$3,140 $3,736 $4,094 
The accompanying notes are an integral part of these condensed consolidated financial statements.
7


Baxter International Inc.
Notes to Condensed Consolidated Financial Statements (unaudited)
1. BASIS OF PRESENTATION
The unaudited interim condensed consolidated financial statements of Baxter International Inc. and its subsidiaries (we or our) have been prepared pursuant to the rules and regulations of the Securities and Exchange Commission (SEC). Accordingly, certain information and footnote disclosures normally included in financial statements prepared in accordance with U.S. generally accepted accounting principles (U.S. GAAP) in the United States have been condensed or omitted. These unaudited interim condensed consolidated financial statements should be read in conjunction with the consolidated financial statements and notes included in our Current Report on Form 8-K filed with the SEC on April 29, 2021 (2020 Annual Report), which revised and superseded the corresponding sections of the Annual Report on Form 10-K for the year ended December 31, 2020.
In the opinion of management, the unaudited interim condensed consolidated financial statements reflect all adjustments necessary for a fair presentation of the financial position, results of operations and cash flows for the periods presented. All such adjustments, unless otherwise noted herein, are of a normal, recurring nature. The results of operations for the current interim period are not necessarily indicative of the results of operations to be expected for the full year.
Certain reclassifications have been made to conform the prior period condensed consolidated statements to the current period presentation.
Risks and Uncertainties Related to COVID-19
Our global operations expose us to risks associated with public health crises and epidemics/pandemics, such as the novel strain of coronavirus (COVID-19). COVID-19 has had, and we expect will continue to have, an adverse impact on our operations, supply chains and distribution systems and has increased and will continue to increase our expenses, including as a result of impacts associated with preventive and precautionary measures that we, other businesses and governments are taking. These measures have led to unprecedented restrictions on, disruptions in, and other related impacts on businesses and personal activities. In addition to travel restrictions put in place in early 2020, governments have closed borders, imposed prolonged quarantines and may continue those measures or implement other restrictions and requirements in light of the continuing spread of the pandemic. We expect that these evolving restrictions and requirements will continue to have an adverse effect on our business.
2. ACQUISITIONS AND OTHER ARRANGEMENTS
Transderm Scop
In March 2021, we acquired the rights to Transderm Scop (TDS) for the U.S. and specified territories outside of the U.S. from subsidiaries of GlaxoSmithKline for an upfront purchase price of $60 million including the cost of acquired inventory and the potential for additional cash consideration of $30 million, which had an acquisition-date fair value of $24 million, based upon regulatory approval of a new contract manufacturer by a specified date. We previously sold this product under a distribution license to the U.S. institutional market. TDS is indicated for post-operative nausea and vomiting in the U.S. and motion sickness in European markets. We concluded that the acquired assets met the definition of a business and accounted for the transaction as a business combination using the acquisition method of accounting. The fair value of the potential contingent consideration payment was estimated by applying a probability-weighted expected payment model and is a Level 3 fair value measurement due to the significant estimates and assumptions used by management in establishing the estimated fair value.

The following table summarizes the fair value of the consideration transferred:
(in millions)
Cash$60 
Contingent Consideration24 
Total Consideration$84 

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The following table summarizes the fair value of the assets acquired as of the acquisition date:
(in millions)
Assets acquired
Inventory$16 
Goodwill1 
Other intangible assets67 
Total assets required$84 

The valuation of the assets acquired are preliminary and measurement period adjustments may be recorded in the future as we finalize our fair value estimates. The results of operations of the acquired business have been included in our consolidated statement of income since the date the business was acquired and were not material for the three and six months ended June 30, 2021.

We allocated $64 million of the total consideration to the TDS developed product rights with an estimated useful life of 9 years and $3 million to customer relationships with an estimated useful life of 7 years. The fair values of the intangible assets were determined using the income approach. The discount rates used to measure the intangible assets were 22.5% for developed product rights and 15.5% for customer relationships. We consider the fair value of the intangible assets to be Level 3 measurements due to the significant estimates and assumptions used by management in establishing the estimated fair values.

The goodwill, which is deductible for tax purposes, includes the value of overall strategic benefits provided to our pharmaceutical portfolio and is included in the Americas and EMEA segments.

We have not presented pro forma financial information for the acquisition because its results are not material to our consolidated financial statements.
Caelyx and Doxil
In February 2021, we acquired the rights to Caelyx and Doxil, the branded versions of liposomal doxorubicin, from a subsidiary of Johnson & Johnson for specified territories outside of the U.S. We previously acquired the U.S. rights to this product in 2019. Liposomal doxorubicin is a chemotherapy medicine used to treat various types of cancer. The transaction was accounted for as an asset acquisition, as substantially all of the fair value of the gross assets acquired was concentrated in the developed technology intangible asset. The purchase price of $325 million was allocated to the assets acquired, which included a $314 million developed-technology intangible asset with an estimated useful life of 9 years and an $11 million customer relationship intangible asset with an estimated useful life of 8 years. Net sales related to this acquisition were $28 million and $41 million, respectively, for the three and six months ended June 30, 2021.
PerClot
In July 2021, we acquired certain assets related to PerClot Polysaccharide Hemostatic System (PerClot), including distribution rights for the U.S. and specified territories outside of the U.S., from CryoLife, Inc. for an upfront purchase price of $25 million and the potential for additional cash consideration of up to $36 million based upon regulatory and commercial milestones. PerClot is an absorbable powder hemostat indicated for use in surgical procedures, including cardiac, vascular, orthopedic, spinal, neurological, gynecological, ENT and trauma surgery as an adjunct hemostat when control of bleeding from capillary, venous, or arteriolar vessels by pressure, ligature, and other conventional means is either ineffective or impractical. PerClot is approved for distribution in the European Union and other markets and is expected to be submitted for Pre-Market Approval (PMA) for distribution in the U.S. in the second half of 2021.
3. SUPPLEMENTAL FINANCIAL INFORMATION
Interest Expense, Net
Three months ended
June 30,
Six months ended
June 30,
(in millions)2021202020212020
Interest expense, net of capitalized interest$37 $40 $74 $70 
Interest income(3)(4)(6)(13)
Interest expense, net$34 $36 $68 $57 
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Other (Income) Expense, Net
Three months ended
June 30,
Six months ended
June 30,
(in millions)2021202020212020
Foreign exchange (gains) losses, net$8 $10 $5 $21 
Pension and other postretirement benefit plans3 (1)7 (2)
Change in fair value of marketable equity securities(9) (7) 
Other, net(4)(3)(2)(3)
Other (income) expense, net$(2)$6 $3 $16 
Allowance for Doubtful Accounts
The following table is a summary of the changes in our allowance for doubtful accounts for the three and six months ended June 30, 2021 and 2020.
Three months ended
June 30,
Six months ended
June 30,
(in millions)2021202020212020
Balance at beginning of period$120 $114 $125 $112 
Adoption of new accounting standard   4 
Charged to costs and expenses(4)5 (3)12 
Write-offs(1)(1)(1)(1)
Currency translation adjustments2 2 (4)(7)
Balance at end of period$117 $120 $117 $120 
Inventories
(in millions)June 30,
2021
December 31,
2020
Raw materials$474 $460 
Work in process225 196 
Finished goods1,366 1,260 
Inventories$2,065 $1,916 
Property, Plant and Equipment, Net
(in millions)June 30,
2021
December 31,
2020
Property, plant and equipment, at cost$11,261 $11,271 
Accumulated depreciation(6,612)(6,549)
Property, plant and equipment, net$4,649 $4,722 
Non-Cash Operating and Investing Activities
Right-of-use operating lease assets obtained in exchange for lease obligations for the six months ended June 30, 2021 and 2020 were $21 million and $35 million, respectively. Right-of-use finance lease assets obtained in exchange for lease obligations for the six months ended June 30, 2020 were $7 million. As of June 30, 2021, we have entered into lease agreements with aggregate future lease payments of approximately $46 million for facilities and equipment that have not yet commenced.
Purchases of property, plant and equipment included in accounts payable as of June 30, 2021 and 2020 were $70 million and $42 million, respectively.
Unsettled share repurchases included in accrued expenses and other current liabilities were $35 million as of June 30, 2021. There were no unsettled share repurchases as of June 30, 2020.
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4. GOODWILL AND OTHER INTANGIBLE ASSETS, NET
Goodwill
The following is a reconciliation of goodwill by business segment.
(in millions)AmericasEMEAAPACTotal
Balance as of December 31, 2020$2,574 $406 $237 $3,217 
Reallocation of goodwill81 (81)  
Acquisitions1   1 
Currency translation(58)(7)(5)(70)
Balance as of June 30, 2021$2,598 $318 $232 $3,148 
As of June 30, 2021, there were no reductions in goodwill relating to impairment losses.
As discussed in Note 16 - Segment Information, we made a change to our reportable segments in the first quarter of 2021. As a result of this change, we reallocated goodwill from our EMEA segment to the Americas segment using a relative fair value approach. In addition, we completed an assessment of any potential goodwill impairment for all reporting units immediately prior to the reallocation and determined that no impairment existed.
Other intangible assets, net
The following is a summary of our other intangible assets.
(in millions)Developed technology, including patentsOther amortized intangible assetsIndefinite-lived intangible assets
Total
June 30, 2021
Gross other intangible assets$3,044 $501 $169 $3,714 
Accumulated amortization(1,462)(342)— (1,804)
Other intangible assets, net$1,582 $159 $169 $1,910 
December 31, 2020
Gross other intangible assets$2,713 $495 $169 $3,377 
Accumulated amortization(1,374)(332)— (1,706)
Other intangible assets, net$1,339 $163 $169 $1,671 
Intangible asset amortization expense was $67 million and $56 million for the three months ended June 30, 2021 and 2020, respectively, and $131 million and $108 million for the six months ended June 30, 2021 and 2020, respectively.
In the second quarter of 2020, we recognized an impairment charge of $17 million related to a developed-technology intangible asset due to a decline in market expectations for the related product. The fair value of the intangible asset was measured using a discounted cash flow approach and the charge is classified within cost of sales in the accompanying condensed consolidated statement of income. We consider the fair value of the asset to be a Level 3 measurement due to the significant estimates and assumptions we used in establishing the estimated fair value.
5. FINANCING ARRANGEMENTS
Significant Debt Activity
In 2020, we issued $500 million of 3.95% senior notes due in April 2030 and $650 million of 1.73% senior notes due in 2031 (the Notes). In conjunction with the issuances of the Notes, we entered into registration rights agreements in which we agreed to file a registration statement with the SEC with respect to an offer to exchange the Notes for new
11


issues of Notes with the same terms registered under the Securities Act of 1933. Those exchange offers with respect to the Notes were completed in May 2021.
In July 2021, Baxter redeemed $400 million in 1.7% Senior Notes due August 2021, which was partially funded by the issuance of commercial paper.
Credit Facilities
Our U.S. dollar-denominated revolving credit facility has a capacity of $2.0 billion and our Euro-denominated revolving credit facility has a capacity of approximately €200 million. As of June 30, 2021 and December 31, 2020, there were no borrowings outstanding under our U.S. dollar or Euro-denominated credit facilities.
Commercial Paper
As of June 30, 2021, we had $50 million of commercial paper outstanding with a weighted-average interest rate of 0.3%. There was no commercial paper outstanding as of December 31, 2020.
6. COMMITMENTS AND CONTINGENCIES
We are involved in product liability, patent, commercial, and other legal matters that arise in the normal course of our business. We record a liability when a loss is considered probable and the amount can be reasonably estimated. If the reasonable estimate of a probable loss is a range, and no amount within the range is a better estimate, the minimum amount in the range is accrued. If a loss is not probable or a probable loss cannot be reasonably estimated, no liability is recorded. As of June 30, 2021 and December 31, 2020, our total recorded reserves with respect to legal and environmental matters were $72 million and $40 million, respectively, and we had a $7 million insurance receivable as of June 30, 2021.
We have established reserves for certain of the matters discussed below. We are not able to estimate the amount or range of any loss for certain contingencies for which there is no reserve or additional loss for matters already reserved. While our liability in connection with these claims cannot be estimated and the resolution thereof in any reporting period could have a significant impact on our results of operations and cash flows for that period, the outcome of these legal proceedings is not expected to have a material adverse effect on our consolidated financial position. While we believe that we have valid defenses in the matters set forth below, litigation is inherently uncertain, excessive verdicts do occur, and we may incur material judgments or enter into material settlements of claims.
In addition to the matters described below, we remain subject to the risk of future administrative and legal actions. With respect to governmental and regulatory matters, these actions may lead to product recalls, injunctions, and other restrictions on our operations and monetary sanctions, including significant civil or criminal penalties. With respect to intellectual property, we may be exposed to significant litigation concerning the scope of our and others’ rights. Such litigation could result in a loss of patent protection or the ability to market products, which could lead to a significant loss of sales, or otherwise materially affect future results of operations.
Environmental
We are involved as a potentially responsible party (PRP) for environmental clean-up costs at six Superfund sites. Under the U.S. Superfund statute and many state laws, generators of hazardous waste sent to a disposal or recycling site are liable for site cleanup if contaminants from that property later leak into the environment. The laws generally provide that a PRP may be held jointly and severally liable for the costs of investigating and remediating the site. Separate from these Superfund cases, we are involved in an ongoing voluntary environmental remediation associated with historic operations at our Irvine, California, United States facility. As of June 30, 2021 and December 31, 2020, our environmental reserves, which are measured on an undiscounted basis, were $19 million and $20 million, respectively. After considering these reserves, the outcome of these matters is not expected to have a material adverse effect on our financial position or results of operations.
General Litigation
In November 2016, a putative antitrust class action complaint seeking monetary and injunctive relief was filed in the United States District Court for the Northern District of Illinois. The complaint alleges a conspiracy among manufacturers of IV solutions to restrict output and affect pricing in connection with a shortage of such solutions. Similar parallel actions subsequently were filed. In January 2017, a single consolidated complaint covering these matters was filed in the Northern District of Illinois. We filed a motion to dismiss the consolidated complaint in February 2017. The court granted our motion to dismiss the consolidated complaint without prejudice in July 2018.
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The plaintiffs filed an amended complaint, which we moved to dismiss on November 9, 2018. The court granted our motion to dismiss the amended complaint with prejudice on April 3, 2020. The plaintiffs did not file an appeal.
In April 2017, we became aware of a criminal investigation by the U.S. Department of Justice (DOJ), Antitrust Division and a federal grand jury in the United States District Court for the Eastern District of Pennsylvania. We and an employee received subpoenas seeking production of documents and testimony regarding the manufacturing, selling, pricing and shortages of IV solutions and containers (including saline solutions and certain other injectable medicines sold by us) and communications with competitors regarding the same. On November 30, 2018, the DOJ notified us that it had closed the investigation. The New York Attorney General had also requested that we provide information regarding business practices in the IV saline industry. We cooperated with that request and have been advised that the matter has now been closed.
In August 2019, we were named in an amended complaint filed by Fayette County, Georgia in the MDL In re: National Prescription Opiate Litigation pending in the U.S. District Court, Northern District of Ohio. The complaint alleges that multiple manufacturers and distributors of opiate products improperly marketed and diverted these products, which caused harm to Fayette County. The complaint is limited in its allegations as to Baxter and does not distinguish between injectable opiate products and orally administered opiates. We manufactured generic injectable opiate products in our facility in Cherry Hill, NJ, which we divested in 2011.
In November 2019, we and certain of our officers were named in a class action complaint captioned Ethan E. Silverman et al. v. Baxter International Inc. et al. that was filed in the United States District Court for the Northern District of Illinois. The plaintiff, who allegedly purchased shares of our common stock during the specified class period, filed this putative class action on behalf of himself and shareholders who acquired Baxter common stock between February 21, 2019 and October 23, 2019. The plaintiff alleges that we and certain officers violated Sections 10(b) and 20(a) of the Securities Exchange Act of 1934 and Rule 10b-5 promulgated thereunder by making allegedly false and misleading statements and failing to disclose material facts relating to certain intra-company transactions undertaken for the purpose of generating foreign exchange gains or avoiding foreign exchange losses, as well as our internal controls over financial reporting. On January 29, 2020, the Court appointed Varma Mutual Pension Insurance Company and Louisiana Municipal Police Employees Retirement System as lead plaintiffs in the case. Plaintiffs filed an amended complaint on June 25, 2020 containing substantially the same allegations. On August 24, 2020, we filed a motion to dismiss the amended complaint. On January 12, 2021, the Court granted our motion to dismiss the amended complaint but gave plaintiffs an opportunity to file a further-amended complaint. The parties reached an agreement to settle the case for $16 million, subject to the completion of confirmatory discovery and final approval by the Court. The Court granted preliminary approval of the settlement on April 20, 2021. A final approval hearing is currently scheduled for August 10, 2021. We are fully reserved for the settlement amount as of June 30, 2021.
In addition, we have received a stockholder request for inspection of our books and records in connection with the announcement made in our Form 8-K on October 24, 2019 that we had commenced an internal investigation into certain intra-company transactions that impacted our previously reported non-operating foreign exchange gains and losses. As initially disclosed on October 24, 2019, we also voluntarily advised the staff of the SEC of our internal investigation and we are continuing to cooperate with the staff of the SEC.
In March 2020, two lawsuits were filed against us in the Northern District of Illinois by plaintiffs alleging injuries as a result of exposure to ethylene oxide used in our manufacturing facility in Mountain Home, Arkansas to sterilize certain of our products. The plaintiffs seek damages, including compensatory and punitive damages in an unspecified amount, and unspecified injunctive and declaratory relief.
7. STOCKHOLDERS’ EQUITY
Stock Options Award Modification
In the first quarter of 2020, we modified the terms of stock option awards granted to 123 employees. Specifically, we extended the term for certain stock options that were scheduled to expire in the first quarter of 2020 as applicable employees were not permitted to exercise these awards due to our announcement in February 2020 that our previously issued financial statements should no longer be relied upon. The stock options were extended in order to allow impacted employees to exercise their stock option awards for a brief period once we became current with our SEC reporting obligations, which occurred in March 2020. As a result of the modifications, we recognized an additional $8 million of stock compensation expense during the quarter ended March 31, 2020.
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Cash Dividends
Cash dividends declared per share for the three and six months ended June 30, 2021 were $0.28 and $0.525, respectively. Cash dividends declared per share for the three and six months ended June 30, 2020 were $0.245 and $0.465, respectively.
Stock Repurchase Programs
In July 2012, the Board of Directors authorized the repurchase of up to $2.0 billion of our common stock. The Board of Directors increased this authority by an additional $1.5 billion in each of November 2016 and February 2018, by an additional $2.0 billion in November 2018 and by an additional $1.5 billion in October 2020. During the first half of 2021, we repurchased 7.3 million shares under this authority pursuant to Rule 10b5-1 plans. During the first half of 2020, we did not repurchase any shares under this authority. As of June 30, 2021, we recognized a liability within accrued expenses and other current liabilities of $35 million for share repurchases that settled in July 2021. We had $1.3 billion remaining available under the authorization as of June 30, 2021.
8. ACCUMULATED OTHER COMPREHENSIVE INCOME
Comprehensive income includes all changes in stockholders’ equity that do not arise from transactions with stockholders, and consists of net income, currency translation adjustments (CTA), certain gains and losses from pension and other postretirement employee benefit (OPEB) plans and gains and losses on cash flow hedges.
The following table is a net-of-tax summary of the changes in accumulated other comprehensive (loss) income (AOCI) by component for the six months ended June 30, 2021 and 2020.
(in millions)CTAPension and OPEB plansHedging activitiesTotal
Gains (losses)
Balance as of December 31, 2020
$(2,587)$(574)$(153)$(3,314)
Other comprehensive income (loss) before reclassifications(120)8 1 (111)
Amounts reclassified from AOCI (a) 33 16 49 
Net other comprehensive income (loss)(120)41 17 (62)
Balance as of June 30, 2021$(2,707)$(533)$(136)$(3,376)
(in millions)CTAPension and OPEB plansHedging activitiesTotal
Gains (losses)
Balance as of December 31, 2019$(2,954)$(715)$(41)$(3,710)
Other comprehensive income (loss) before
reclassifications
(170)2 (131)(299)
Amounts reclassified from AOCI (a) 24 (3)21 
Net other comprehensive income (loss)(170)26 (134)(278)
Balance as of June 30, 2020$(3,124)$(689)$(175)$(3,988)
(a)    See table below for details about these reclassifications.
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The following is a summary of the amounts reclassified from AOCI to net income during the three and six months ended June 30, 2021 and 2020.
Amounts reclassified from AOCI (a)
(in millions)Three months ended June 30, 2021Six months ended
June 30, 2021
Location of impact in income statement
Amortization of pension and OPEB items
Amortization of net losses and prior service costs or credits$(20)$(41)Other (income) expense, net
Less: Tax effect4 8 Income tax expense
$(16)$(33)Net of tax
Gains (losses) on hedging activities
Foreign exchange contracts$(8)$(18)Cost of sales
Interest rate contracts$(2)(3)Interest expense, net
(10)(21)Total before tax
Less: Tax effect3 5 Income tax expense
$(7)$(16)Net of tax
Total reclassifications for the period$(23)$(49)Total net of tax

(a)    Amounts in parentheses indicate reductions to net income
Amounts reclassified from AOCI (a)
(in millions)Three months ended June 30, 2020Six months ended June 30, 2020Location of impact in income statement
Amortization of pension and OPEB items
Amortization of net losses and prior service costs or credits$(15)$(30)Other (income) expense, net
Less: Tax effect3 6 Income tax expense
$(12)$(24)Net of tax
Gains on hedging activities
Foreign exchange contracts$5 $4 Cost of sales
Less: Tax effect(1)(1)Income tax expense
$4 $3 Net of tax
Total reclassifications for the period$(8)$(21)Total net of tax
Refer to Note 11 for additional information regarding the amortization of pension and OPEB items and Note 14 for additional information regarding hedging activity.
9. REVENUES
Revenue is measured as the amount of consideration we expect to receive in exchange for transferring goods or providing services. A performance obligation is a promise in a contract to transfer a distinct good or service to the customer and is the unit of account in the contract. A contract’s transaction price is allocated to each distinct performance obligation and recognized as revenue when, or as, the performance obligation is satisfied. Some of our contracts have multiple performance obligations. For contracts with multiple performance obligations, we allocate the contract’s transaction price to each performance obligation using our best estimate of the standalone selling price of each distinct good or service in the contract. Our global payment terms are typically between 30-90 days.
The majority of our performance obligations are satisfied at a point in time. This includes sales of our broad portfolio of essential healthcare products across our geographic segments including acute and chronic dialysis therapies; sterile IV solutions; infusion systems and devices; parenteral nutrition therapies; inhaled anesthetics; generic injectable pharmaceuticals; and surgical hemostat and sealant products. For a majority of these sales, our performance obligation is satisfied upon delivery to the customer. Shipping and handling activities are considered to be fulfillment activities and are not considered to be a separate performance obligation.
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To a lesser extent, in all of our segments, we enter into other types of contracts including contract manufacturing arrangements, equipment leases, and certain subscription software and licensing arrangements. We recognize revenue for these arrangements over time or at a point in time depending on our evaluation of when the customer obtains control of the promised goods or services. Revenue is recognized over time when we are creating or enhancing an asset that the customer controls as the asset is created or enhanced or our performance does not create an asset with an alternative use and we have an enforceable right to payment for performance completed.
As of June 30, 2021, we had $8.7 billion of transaction price allocated to remaining performance obligations related to executed contracts with an original duration of one year or more, which are primarily included in the Americas segment. Some contracts in the United States included in this amount contain index-dependent price increases, which are not known at this time. We expect to recognize approximately 20% of this amount as revenue over the remainder of 2021, 30% in 2022, 25% in 2023, 15% in 2024 and 10% in 2025.
Significant Judgments
Revenues from product sales are recorded at the net sales price (transaction price), which includes estimates of variable consideration primarily related to rebates and wholesaler chargebacks. These reserves are based on estimates of the amounts earned or to be claimed on the related sales and are included in accrued expenses and other current liabilities and accounts receivable, net on the condensed consolidated balance sheets. Management's estimates take into consideration historical experience, current contractual and statutory requirements, specific known market events and trends, industry data, and forecasted customer buying and payment patterns. Overall, these reserves reflect our best estimates of the amount of consideration to which we are entitled based on the terms of the contract using the expected value method. The amount of variable consideration included in the net sales price is limited to the amount for which it is probable that a significant reversal in revenue will not occur when the related uncertainty is resolved. Revenue recognized during the three and six months ended June 30, 2021 and 2020 related to performance obligations satisfied in prior periods was not material. Additionally, our contracts with customers often include promises to transfer multiple products and services to a customer. Determining whether products and services are considered distinct performance obligations that should be accounted for separately and determining the allocation of the transaction price may require significant judgement.
Contract Balances
The timing of revenue recognition, billings and cash collections results in the recognition of trade accounts receivable, unbilled receivables, contract assets and customer advances and deposits (contract liabilities) on our condensed consolidated balance sheets. Net trade accounts receivable was $1.8 billion and $1.7 billion as of June 30, 2021 and December 31, 2020, respectively.
For contract manufacturing arrangements, revenue is primarily recognized throughout the production cycle, which typically lasts up to 90 days, resulting in the recognition of contract assets until the related services are completed and the customers are billed. Additionally, for arrangements containing a performance obligation to deliver software that can be used with medical devices, we recognize revenue upon delivery of the software, which results in the recognition of contract assets when customers are billed over time, generally over one to five years. For bundled contracts involving equipment delivered up-front and consumable medical products to be delivered over time, total contract revenue is allocated between the equipment and consumable medical products. In certain of those arrangements, a contract asset is created for the difference between the amount of equipment revenue recognized upon delivery and the amount of consideration initially receivable from the customer. In those arrangements, the contract asset becomes a trade account receivable as consumable medical products are provided and billed, generally over one to seven years.
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The following table summarizes our contract assets:
(in millions)June 30,
2021
December 31,
2020
Contract manufacturing services$72 $47 
Software sales39 40 
Bundled equipment and consumable medical products contracts50 47 
Contract assets$161 $134 
The following table summarizes the classification of contract assets and contract liabilities as reported in the condensed consolidated balance sheets:
(in millions)June 30,
2021
December 31,
2020
Prepaid expenses and other current assets$98 $70 
Other non-current assets63 64 
Contract assets$161 $134 
Accrued expenses and other current liabilities$43 $32 
Other non-current liabilities44 34 
Contract liabilities$87 $66 
Contract liabilities are recognized when a customer pays consideration before we transfer goods or provide services. During the six months ended June 30, 2021 and 2020, the amount of revenue recognized that was included in contract liabilities as of December 31, 2020 and 2019 was not significant.
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Disaggregation of Net Sales
Beginning in the first quarter of 2021, our product category net sales disclosures (previously referred to as global business units (GBUs)) separately present net sales from our BioPharma Solutions business, which was previously included within Other. Concurrent with that disaggregation of net sales from our BioPharma Solutions business, we have also allocated certain previously unallocated sales deductions from Other to various categories, primarily based on their respective net sales. Net sales for the three and six months ended June 30, 2020 have been recast to conform to the current period presentation.
The following tables disaggregate our net sales from contracts with customers by product category between the U.S. and international:
Three Months Ended June 30,
20212020
(in millions)U.S.InternationalTotalU.S.InternationalTotal
Renal Care 1
$217 $747 $964 $209 $710 $919 
Medication Delivery 2
444 253 697 394 211 605 
Pharmaceuticals 3
162 384 546 208 273 481 
Clinical Nutrition 4
84 153 237 75 141 216 
Advanced Surgery 5
144 112 256 94 74 168 
Acute Therapies 6
61 127 188 72 114 186 
BioPharma Solutions 7
65 118 183 54 62 116 
Other 8
21 6 27 21 6 27 
Total Baxter$1,198 $1,900 $3,098 $1,127 $1,591 $2,718 

Six Months Ended June 30,
20212020
(in millions)U.S.InternationalTotalU.S.InternationalTotal
Renal Care 1
$433 $1,453 $1,886 $413 $1,376 $1,789 
Medication Delivery 2
855 494 1,349 843 440 1,283 
Pharmaceuticals 3
362 736 1,098 428 569 997 
Clinical Nutrition 4
167 304 471 154 279 433 
Advanced Surgery 5
270 203 473 231 161 392 
Acute Therapies 6
142 253 395 132 210 342 
BioPharma Solutions 7
109 209 318 102 128 230 
Other 8
40 14 54 41 13 54 
Total Baxter$2,378 $3,666 $6,044 $2,344 $3,176 $5,520 

1Renal Care includes sales of our peritoneal dialysis (PD), hemodialysis (HD) and additional dialysis therapies and services.
2Medication Delivery includes sales of our intravenous (IV) therapies, infusion pumps, administration sets and drug reconstitution devices.
3Pharmaceuticals includes sales of our premixed and oncology drug platforms, inhaled anesthesia and critical care products and pharmacy compounding services.
4Clinical Nutrition includes sales of our parenteral nutrition (PN) therapies and related products.
5Advanced Surgery includes sales of our biological products and medical devices used in surgical procedures for hemostasis, tissue sealing and adhesion prevention.
6Acute Therapies includes sales of our continuous renal replacement therapies (CRRT) and other organ support therapies focused in the intensive care unit (ICU).
7BioPharma Solutions includes sales of contracted services we provide to various pharmaceutical and biopharmaceutical companies.
8Other includes sales of miscellaneous product and service offerings.
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Lease Revenue
We lease medical equipment, such as renal dialysis equipment and infusion pumps, to customers, primarily in conjunction with arrangements to provide consumable medical products such as dialysis therapies, IV fluids and inhaled anesthetics. Certain of our equipment leases are classified as sales-type leases and the remainder are operating leases. The terms of the related contracts, including the proportion of fixed versus variable payments and any options to shorten or extend the lease term, vary by customer. We allocate revenue between equipment leases and medical products based on their standalone selling prices.
The components of lease revenue for the three and six months ended June 30, 2021 were:
(in millions)Three months ended June 30, 2021Six months ended June 30, 2021
Sales-type lease revenue$10 $16 
Operating lease revenue35 69 
Variable lease revenue15 32 
Total lease revenue$60 $117 
The components of lease revenue for the three and six months ended June 30, 2020 were:
(in millions)Three months ended June 30, 2020Six months ended June 30, 2020
Sales-type lease revenue$10 $16 
Operating lease revenue14 28 
Variable lease revenue20 38 
Total lease revenue$44 $82 
Our net investment in sales-type leases was $125 million as of June 30, 2021, of which $17 million originated in 2017 and prior, $33 million in 2018, $27 million in 2019, $35 million in 2020 and $13 million in 2021.
10. BUSINESS OPTIMIZATION CHARGES
In recent years, we have undertaken actions to transform our cost structure and enhance operational efficiency. These efforts include restructuring the organization, optimizing the manufacturing footprint, R&D operations and supply chain network, employing disciplined cost management, and centralizing and streamlining certain support functions. From the commencement of our business optimization activities in the second half of 2015 through June 30, 2021, we have incurred cumulative pre-tax costs of $1.2 billion related to these actions. The costs consisted primarily of employee termination costs, implementation costs, contract termination costs, asset impairments and accelerated depreciation. We currently expect to incur additional pre-tax costs of approximately $16 million through the completion of the initiatives that are currently underway, primarily related to implementation costs. We continue to pursue cost savings initiatives and, to the extent further cost savings opportunities are identified, we may incur additional restructuring charges and costs to implement business optimization programs in future periods.

During the three and six months ended June 30, 2021 and 2020, we recorded the following charges related to business optimization programs.
Three Months Ended June 30,Six Months Ended June 30,
(in millions)2021202020212020
Restructuring charges$10 $7 $35 $32 
Costs to implement business optimization programs8 6 10 13 
Total business optimization charges$18 $13 $45 $45 
For segment reporting purposes, business optimization charges are unallocated expenses.
Costs to implement business optimization programs for the three and six months ended June 30, 2021 and 2020, respectively, consisted primarily of external consulting and transition costs, including employee compensation and related costs. These costs were primarily included within cost of sales and SG&A expense.
19


During the three and six months ended June 30, 2021 and 2020, we recorded the following restructuring charges.
Three months ended June 30, 2021
(in millions)COGSSG&AR&DTotal
Employee termination costs$8 $1 $ $9 
Asset impairments1   1 
Total restructuring charges$9 $1 $ $10 
Three months ended June 30, 2020
(in millions)COGSSG&AR&DTotal
Employee termination costs$3 $3 $(3)$3 
Contract termination and other costs2   2 
Asset impairments2   2 
Total restructuring charges$7 $3 $(3)$7 
Six months ended June 30, 2021
(in millions)COGSSG&AR&DTotal
Employee termination costs$24 $6 $ $30 
Asset impairments5   5 
Total restructuring charges$29 $6 $ $35 
Six months ended June 30, 2020
(in millions)COGSSG&AR&DTotal
Employee termination costs$5 $19 $(2)$22 
Contract termination and other costs2   2 
Asset impairments8   8 
Total restructuring charges$15 $19 $(2)$32 
In conjunction with our business optimization initiatives in the first quarter of 2020, we sold property that resulted in a gain of $17 million. This gain is reflected within other operating income, net in our condensed consolidated statement of income for the six months ended June 30, 2020.
The following table summarizes activity in the liability related to our restructuring initiatives.
(in millions)
Liability balance as of December 31, 2020$113 
Charges33 
Payments(46)
Reserve adjustments(3)
Currency translation(3)
Liability balance as of June 30, 2021$94 
Substantially all of our restructuring liabilities as of June 30, 2021 relate to employee termination costs, with the remaining liabilities attributable to contract termination costs. Substantially all of the cash payments for those liabilities are expected to be disbursed by the end of 2022.
20


11. PENSION AND OTHER POSTRETIREMENT BENEFIT PROGRAMS
The following is a summary of net periodic benefit cost relating to our pension and OPEB plans.
Three months ended
June 30,
Six months ended
June 30,
(in millions)2021202020212020
Pension benefits
Service cost$22 $20 $44 $41 
Interest cost18 23 36 47 
Expected return on plan assets(36)(40)(72)(81)
Amortization of net losses and prior service costs23 19 46 38 
Net periodic pension cost$27 $22 $54 $45 
OPEB
Interest cost$1 $1 $2 $2 
Amortization of net loss and prior service credit(3)(4)(5)(8)
Net periodic OPEB cost (income)$(2)$(3)$(3)$(6)

12. INCOME TAXES
Our effective income tax rate was 23.2% and 14.5% for the three months ended June 30, 2021 and 2020, respectively, and 19.1% and 13.0% for the six months ended June 30, 2021 and 2020, respectively. Our effective income tax rate can differ from the 21% U.S. federal statutory rate due to a number of factors, including foreign rate differences, tax incentives, increases or decreases in valuation allowances and liabilities for uncertain tax positions and excess tax benefits on stock compensation awards.
For the three months ended June 30, 2021, the difference between our effective income tax rate and the U.S. federal statutory rate was primarily attributable to an unfavorable court decision in a foreign jurisdiction related to an uncertain tax position.
For the six months ended June 30, 2021, the difference between our effective income tax rate and the U.S. federal statutory rate was primarily attributable to a favorable geographic earnings mix and decreases in accrued withholding taxes in several foreign jurisdictions, partially offset by an unfavorable court decision in a foreign jurisdiction related to an uncertain tax position.
For the three and six months ended June 30, 2020, the difference between our effective income tax rate and the U.S. federal statutory rate was primarily attributable to a favorable geographic earnings mix and excess tax benefits on stock compensation awards.
13. EARNINGS PER SHARE
The numerator for both basic and diluted earnings per share (EPS) is net income attributable to Baxter stockholders. The denominator for basic EPS is the weighted-average number of shares outstanding during the period. The dilutive effect of outstanding stock options, RSUs and PSUs is reflected in the denominator for diluted EPS using the treasury stock method.
The following table is a reconciliation of basic shares to diluted shares.
Three months ended
June 30,
Six months ended
June 30,
(in millions)2021202020212020
Basic shares503 509 504 508 
Effect of dilutive securities6 8 6 9 
Diluted shares509 517 510 517 
The effect of dilutive securities includes unexercised stock options, unvested RSUs and contingently issuable shares related to granted PSUs. The computation of diluted EPS excludes 7 million equity awards for the three and six months ended June 30, 2021, respectively, and 4 million and 3 million equity awards for the three and six months
21


ended June 30, 2020, respectively, because their inclusion would have had an anti-dilutive effect on diluted EPS. Refer to Note 7 for additional information regarding items impacting basic and diluted shares.
14. DERIVATIVE INSTRUMENTS AND HEDGING ACTIVITIES
We operate on a global basis and are exposed to the risk that our earnings, cash flows and equity could be adversely impacted by fluctuations in foreign exchange and interest rates. Our hedging policy attempts to manage these risks to an acceptable level based on our judgment of the appropriate trade-off between risk, opportunity and costs.
We are primarily exposed to foreign exchange risk with respect to recognized assets and liabilities, forecasted transactions and net assets denominated in the Euro, British Pound, Chinese Renminbi, Korean Won, Australian Dollar, Canadian Dollar, Japanese Yen, Colombian Peso, Brazilian Real, Mexican Peso, Indian Rupee and Swedish Krona. We manage our foreign currency exposures on a consolidated basis, which allows us to net exposures and take advantage of any natural offsets. In addition, we use derivative and nonderivative instruments to further reduce the net exposure to foreign exchange risk. Gains and losses on the hedging instruments offset losses and gains on the hedged transactions and reduce the earnings and equity volatility resulting from changes in foreign exchange rates. Financial market and currency volatility may limit our ability to cost-effectively hedge these exposures.
We are also exposed to the risk that our earnings and cash flows could be adversely impacted by fluctuations in interest rates. Our policy is to manage interest costs using the mix of fixed- and floating-rate debt that we believe is appropriate at that time. To manage this mix in a cost-efficient manner, we periodically enter into interest rate swaps in which we agree to exchange, at specified intervals, the difference between fixed and floating interest amounts calculated by reference to an agreed-upon notional amount.
We do not hold any instruments for trading purposes and none of our outstanding derivative instruments contain credit-risk-related contingent features.
All derivative instruments are recognized as either assets or liabilities at fair value in the condensed consolidated balance sheets and are generally classified as short-term or long-term based on the scheduled maturity of the instrument. We designate certain of our derivatives and foreign-currency denominated debt as hedging instruments in cash flow, fair value, or net investment hedges.
Cash Flow Hedges
We may use options, including collars and purchased options, forwards and cross-currency swaps to hedge the foreign exchange risk to earnings relating to forecasted transactions and recognized assets and liabilities. We periodically use treasury rate locks to hedge the risk to earnings associated with movements in interest rates relating to anticipated issuances of debt.
For each derivative instrument that is designated and effective as a cash flow hedge, the gain or loss on the derivative is recorded in AOCI and then recognized in earnings consistent with the underlying hedged item. Option premiums or net premiums paid are initially recorded as assets and reclassified to other comprehensive income (OCI) over the life of the option, and then recognized in earnings consistent with the underlying hedged item. Cash flow hedges are classified in cost of sales and interest expense, net, and are primarily related to forecasted third-party sales denominated in foreign currencies, forecasted intra-company sales denominated in foreign currencies, and forecasted interest payments on anticipated issuances of debt, respectively.
The notional amounts of foreign exchange contracts designated as cash flow hedges were $357 million and $345 million as of June 30, 2021 and December 31, 2020, respectively. The maximum term over which we have cash flow hedge contracts in place related to forecasted transactions at June 30, 2021 is 12 months for foreign exchange contracts. There were no outstanding interest rate contracts designated as cash flow hedges as of June 30, 2021 and December 31, 2020.
Fair Value Hedges
We periodically use interest rate swaps to convert a portion of our fixed-rate debt into variable-rate debt. These instruments hedge our earnings from changes in the fair value of debt due to fluctuations in the designated benchmark interest rate. For each derivative instrument that is designated and effective as a fair value hedge, the gain or loss on the derivative is recognized immediately to earnings, and offsets changes in fair value attributable to a particular risk, such as changes in interest rates, of the hedged item, which are also recognized in earnings. Changes
22


in the fair value of hedge instruments designated as fair value hedges are classified in interest expense, net, as they hedge the interest rate risk associated with certain of our fixed-rate debt.
There were no outstanding interest rate contracts designated as fair value hedges as of June 30, 2021 and December 31, 2020.
Net Investment Hedges
In May 2017, we issued €600 million of senior notes due May 2025. In May 2019, we issued €750 million of senior notes due May 2024 and €750 million of senior notes due May 2029. We have designated these debt obligations as hedges of our net investment in our European operations and, as a result, mark to spot rate adjustments on the outstanding debt balances are recorded as a component of AOCI. As of June 30, 2021, we had an accumulated pre-tax unrealized translation loss in AOCI of $162 million related to the Euro-denominated senior notes.
Dedesignations
If it is determined that a derivative or nonderivative hedging instrument is no longer highly effective as a hedge, we discontinue hedge accounting prospectively. Gains or losses relating to terminations of effective cash flow hedges generally continue to be deferred and are recognized consistent with the loss or income recognition of the underlying hedged items. However, if it is probable that the hedged forecasted transactions will not occur, any gains or losses would be immediately reclassified from AOCI to earnings.
There were no hedge dedesignations in the first six months of 2021 or 2020 resulting from changes in our assessment of the probability that the hedged forecasted transactions would occur.
If we terminate a fair value hedge, an amount equal to the cumulative fair value adjustment to the hedged item at the date of termination is amortized to earnings over the remaining term of the hedged item. There were no fair value hedges terminated during the first six months of 2021 or 2020.
If we remove a net investment hedge designation, any gain or loss recognized in AOCI is not reclassified to earnings until we sell, liquidate, or deconsolidate the foreign investments that were being hedged. There were no net investment hedges terminated during the first six months of 2021 or 2020.
Undesignated Derivative Instruments
We use forward contracts to hedge earnings from the effects of foreign exchange relating to certain of our intra-company and third-party receivables and payables denominated in a foreign currency. These derivative instruments are generally not formally designated as hedges and the terms of these instruments generally do not exceed one month.
The total notional amount of undesignated derivative instruments was $904 million as of June 30, 2021 and $1.0 billion as of December 31, 2020.
Gains and Losses on Hedging Instruments and Undesignated Derivative Instruments
The following tables summarize the gains and losses on our hedging instruments and the classification of those gains and losses within our condensed consolidated financial statements for the three months ended June 30, 2021 and 2020.
Gain (loss) recognized in OCILocation of gain (loss)
in income statement
Gain (loss) reclassified from AOCI into income
(in millions)2021202020212020
Cash flow hedges
Interest rate contracts$ $9 Interest expense, net$(2)$ 
Foreign exchange contracts(3)(7)Cost of sales(8)5 
Net investment hedges(31)(50)Other (income) expense, net  
Total$(34)$(48)$(10)$5 
23


Location of gain (loss) in income statementGain (loss) recognized in income
(in millions)20212020
Undesignated derivative instruments
Foreign exchange contractsOther (income) expense, net$3 $13 
The following tables summarize the gains and losses on our hedging instruments and the classification of those gains and losses within our condensed consolidated financial statements for the six months ended June 30, 2021 and 2020.
Gain (loss) recognized in OCILocation of gain (loss)
in income statement
Gain (loss) reclassified from AOCI
into income
(in millions)2021202020212020
Cash flow hedges
Interest rate contracts$ $(175)Interest expense, net$(3)$ 
Foreign exchange contracts1 7 Cost of sales(18)4 
Net investment hedges83 (1)Other (income) expense, net  
Total$84 $(169)$(21)$4 
Location of gain (loss)
in income statement
Gain (loss) recognized in income
(in millions)20212020
Undesignated derivative instruments
Foreign exchange contractsOther (income) expense, net$(19)$15 
As of June 30, 2021, $9 million of deferred, net after-tax losses on derivative instruments included in AOCI are expected to be recognized in earnings during the next 12 months, coinciding with when the hedged items are expected to impact earnings.
Derivative Assets and Liabilities
The following table summarizes the classification and fair values of derivative instruments reported in the condensed consolidated balance sheet as of June 30, 2021.
Derivatives in asset positionsDerivatives in liability positions
(in millions)Balance sheet locationFair valueBalance sheet locationFair value
Derivative instruments designated as hedges
Foreign exchange contractsPrepaid expenses and other current assets3 Accrued expenses and other current liabilities6 
Total derivative instruments designated as hedges3 6 
Undesignated derivative instruments
Foreign exchange contractsPrepaid expenses and other current assets2 Accrued expenses and other current liabilities9 
Total derivative instruments$5 $15 
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The following table summarizes the classification and fair values of derivative instruments reported in the condensed consolidated balance sheet as of December 31, 2020.
Derivatives in asset positionsDerivatives in liability positions
(in millions)Balance sheet locationFair valueBalance sheet locationFair value
Derivative instruments designated as hedges
Foreign exchange contractsPrepaid expenses and other current assets Accrued expenses and other current liabilities17 
Total derivative instruments designated as hedges 17 
Undesignated derivative instruments
Foreign exchange contractsPrepaid expenses and other current assets11 Accrued expenses and other current liabilities2 
Total derivative instruments$11 $19 
While some of our derivatives are subject to master netting arrangements, we present our assets and liabilities related to derivative instruments on a gross basis within the condensed consolidated balance sheets. Additionally, we are not required to post collateral for any of our outstanding derivatives.
The following table provides information on our derivative positions as if they were presented on a net basis, allowing for the right of offset by counterparty.
June 30, 2021December 31, 2020
(in millions)AssetLiabilityAssetLiability
Gross amounts recognized in the consolidated balance sheet$5 $15 $11 $19 
Gross amount subject to offset in master netting arrangements not offset in the consolidated balance sheet(3)(3)(6)(6)
Total$2 $12 $5 $13 
The following table presents the amounts recorded on the condensed consolidated balance sheet related to fair value hedges:
Carrying amount of hedged itemCumulative amount of fair value hedging adjustment included
 in the carrying amount of the hedged item (a)
(in millions)Balance as of June 30, 2021Balance as of December 31, 2020Balance as of June 30, 2021Balance as of December 31, 2020
Long-term debt$102 $102 $5 $5 
(a) These fair value hedges were terminated in 2018 and earlier periods.
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15. FAIR VALUE MEASUREMENTS
The following tables summarize our assets and liabilities that are measured at fair value on a recurring basis.
Basis of fair value measurement
(in millions)Balance as of June 30, 2021Quoted prices in active markets for identical assets
(Level 1)
Significant other
observable inputs
(Level 2)
Significant
unobservable inputs
(Level 3)
Assets
Foreign exchange contracts$5 $ $5 $ 
Debt securities15  15  
Marketable equity securities24 24   
Total$44 $24 $20 $ 
Liabilities
Foreign exchange contracts$15 $ $15 $ 
Contingent payments related to acquisitions34   34 
Total$49 $ $15 $34 
Basis of fair value measurement
(in millions)Balance as of December 31, 2020Quoted prices in active markets for identical assets
(Level 1)
Significant other
observable inputs
(Level 2)
Significant
unobservable inputs
(Level 3)
Assets
Foreign exchange contracts$11 $ $11 $ 
Debt securities13  13  
Marketable equity securities17 17   
Total$41 $17 $24 $ 
Liabilities
Foreign exchange contracts$19 $ $19 $ 
Contingent payments related to acquisitions30   30 
Total$49 $ $19 $30 
As of June 30, 2021 and December 31, 2020, cash and cash equivalents of $3.1 billion and $3.7 billion, respectively, included money market and other short-term funds of approximately $1.4 billion and $1.8 billion, respectively, which are considered Level 2 in the fair value hierarchy.
For assets that are measured using quoted prices in active markets, the fair value is the published market price per unit multiplied by the number of units held, without consideration of transaction costs. The majority of the derivatives entered into by us are valued using internal valuation techniques as no quoted market prices exist for such instruments. The principal techniques used to value these instruments are discounted cash flow and Black-Scholes models. The key inputs, which are considered observable and vary depending on the type of derivative, include contractual terms, interest rate yield curves, foreign exchange rates and volatility.
Contingent payments related to acquisitions, which consist of milestone payments and sales-based payments, are valued using discounted cash flow techniques. The fair value of milestone payments reflects management’s expectations of probability of payment, and increases as the probability of payment increases or the expected timing of payments is accelerated. The fair value of sales-based payments is based upon probability-weighted future revenue estimates, and increases as revenue estimates increase, probability weighting of higher revenue scenarios increases or the expected timing of payment is accelerated. The following table is a reconciliation of recurring fair value measurements that use significant unobservable inputs (Level 3), which consist of contingent payments related
26


to acquisitions.
Three months ended
June 30,
Six months ended
June 30,
(in millions)2021202020212020
Fair value at beginning of period$38 $39 $30 $39 
Additions  24 4 
Change in fair value recognized in earnings(5) (5)(3)
Payments  (16)(1)
Currency translation 1  1  
Fair value at end of period$34 $39 $34 $39 
Financial Instruments Not Measured at Fair Value
In addition to the financial instruments that we are required to recognize at fair value in the condensed consolidated balance sheets, we have certain financial instruments that are recognized at amortized cost or some basis other than fair value. For these financial instruments, the following table provides the values recognized in the condensed consolidated balance sheets and the estimated fair values as of June 30, 2021 and December 31, 2020.
Book valuesFair values(a)
(in millions)2021202020212020
Liabilities
Short-term debt$51 $ $51 $ 
Current maturities of long-term debt and finance lease obligations406 406 406 409 
Long-term debt and finance lease obligations5,710 5,786 6,236 6,471 
(a)    These fair value amounts are classified as Level 2 within the fair value hierarchy as they are estimated based on observable inputs.
The carrying value of short-term debt approximates its fair value due to the short-term maturities of the obligations. The estimated fair values of long-term debt were computed by multiplying price by the notional amount of the respective debt instruments. Price is calculated using the stated terms of the respective debt instrument and yield curves commensurate with our credit risk. The carrying values of other financial instruments, such as accounts receivable and accounts payable, approximate their fair values due to the short-term maturities of most of those assets and liabilities.
Equity investments not measured at fair value are comprised of other equity investments without readily determinable fair values and were $108 million at June 30, 2021 and $105 million at December 31, 2020. Those investments are included in Other non-current assets on our condensed consolidated balance sheets.
16. SEGMENT INFORMATION
We manage our business based on three geographical segments: Americas (North and South America), EMEA (Europe, Middle East and Africa) and APAC (Asia Pacific). Our segments provide a broad portfolio of essential healthcare products, including acute and chronic dialysis therapies; sterile IV solutions; infusion systems and devices; parenteral nutrition therapies; inhaled anesthetics; generic injectable pharmaceuticals; and surgical hemostat and sealant products. In the first quarter of 2021, the information provided to our Chief Executive Officer for purposes of allocating resources and assessing performance was updated to reallocate contracted services activities performed at a German manufacturing facility from our EMEA segment to our Americas segment. The contracted services performed at that facility are part of our BioPharma Solutions business, which is managed as part of the Americas segment. Accordingly, the reported financial results of the Americas segment now include the contracted services activities performed at that facility. Segment results for the three and six months ended June 30, 2020 have been recast to conform to the current period presentation.
We use operating income on a segment basis to make resource allocation decisions and assess the ongoing performance of our business segments. Intersegment sales are eliminated in consolidation.
Certain items are maintained at Corporate and are not allocated to a segment. They primarily include corporate headquarters costs, certain R&D costs, certain product category support costs, stock compensation expense, certain employee benefit plan costs, certain foreign currency hedging activities, and certain gains, losses, and other charges
27


(such as business optimization, acquisition and integration costs, intangible asset amortization and asset impairments). Our chief operating decision maker does not receive any asset information by operating segment and, accordingly, we do not report asset information by operating segment.
Financial information for our segments is as follows.
Three months ended
June 30,
Six months ended
June 30,
(in millions)2021202020212020
Net sales:
Americas$1,624 $1,469 $3,184 $3,034 
EMEA783 669 1,521 1,357 
APAC691 580 1,339 1,129 
Total net sales$3,098 $2,718 $6,044 $5,520 
Operating income:
Americas$632 $527 $1,231 $1,115 
EMEA159 121 294 238 
APAC152 143 290 271 
Total segment operating income$943 $791 $1,815 $1,624 
The following is a reconciliation of segment operating income to income before income taxes per the condensed consolidated statements of income.
Three months ended
June 30,
Six months ended
June 30,
(in millions)2021202020212020
Total segment operating income$943 $791 $1,815 $1,624 
Corporate and other(519)(460)(1,001)(884)
Total operating income424 331 814 740 
Net interest expense34 36 68 57 
Other (income) expense, net(2)6 3 16 
Income before income taxes$392 $289 $743 $667 
Refer to Note 9 for additional information on Net Sales by product category.
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Item 2.    Management’s Discussion and Analysis of Financial Condition and Results of Operations
Refer to our Current Report on Form 8-K filed with the SEC on April 29, 2021 (2020 Annual Report), which revised and superseded the Management's Discussion and Analysis of Financial Condition and Results of Operations section of the Annual Report on Form 10-K for the year ended December 31, 2020, for management’s discussion and analysis of our financial condition and results of operations. The following is management’s discussion and analysis of our financial condition and results of operations for the three and six months ended June 30, 2021 and 2020.
RESULTS OF OPERATIONS
Net income attributable to Baxter stockholders for the three and six months ended June 30, 2021 totaled $298 million, or $0.59 per diluted share, and $596 million, or $1.17 per diluted share, compared to $246 million, or $0.48 per diluted share, and $578 million, or $1.12 per diluted share, for the three and six months ended June 30, 2020. Net income for the three and six months ended June 30, 2021 included special items which decreased net income by $111 million and $199 million, respectively, or $0.21 and $0.39 per diluted share, respectively, as further discussed below. Net income for the three and six months ended June 30, 2020 included special items which decreased net income by $83 million and $176 million, respectively, or $0.16 and $0.34 per diluted share, respectively, as further discussed below.
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Special Items
The following table provides a summary of our special items and the related impact by line item on our results for the three and six months ended June 30, 2021 and 2020.
Three months ended
June 30,
Six months ended
June 30,
(in millions)2021202020212020
Gross Margin
Intangible asset amortization expense$(67)$(56)$(131)$(108)
Intangible asset impairment1
— (17)— (17)
Business optimization items2
(10)(8)(31)(18)
Acquisition and integration expenses3
— (4)— (11)
European medical devices regulation4
(11)(8)(19)(14)
Investigation and related costs5
— — — (3)
Total Special Items$(88)$(93)$(181)$(171)
Impact on Gross Margin Ratio(2.8 pts)(3.4 pts)(3.0 pts)(3.1 pts)
Selling, General and Administrative (SG&A) Expenses
Business optimization items2
$$$14 $28 
Acquisition and integration expenses3
Investigation and related costs5
17 28 16 
Total Special Items$26 $13 $44 $51 
Impact on SG&A Ratio0.9 pts0.5 pts0.7 pts1.0 pts
Research and Development (R&D) Expenses
Business optimization items2
$— $(2)$— $(1)
Acquisition and integration expenses3
— — 22 
Investigation and related costs5
— — — 
Total Special Items$— $(1)$— $22 
Impact on R&D Ratio0.0 pts0.0 pts0.0 pts0.4 pts
Other Operating Income, net
Business optimization items2
$— $— $— $(17)
Acquisition and integration expenses3
(5)— (5)(3)
Total Special Items$(5)$— $(5)$(20)
Income Tax Expense
Tax matter6
$22 $— $22 $— 
Tax effects of special items7
(20)(22)(43)(48)
Total Special Items$$(22)$(21)$(48)
Impact on Effective Tax Rate5.2 pts(1.7 pts)2.1 pts(2.2 pts)
Intangible asset amortization expense is identified as a special item to facilitate an evaluation of current and past operating performance and is consistent with how management and our Board of Directors assess performance. Additional special items are identified above because they are highly variable, difficult to predict and of a size that may substantially impact our reported results of operations for the period. Management believes that providing the separate impact of those items may provide a more complete understanding and facilitate a fuller analysis of our results of operations, particularly in evaluating performance from one period to another.

1In 2020, our results included a charge of $17 million for an asset impairment related to a developed-technology intangible asset. Refer to Note 5 in Item 1 of this Quarterly Report on Form 10-Q for further information regarding this asset impairment.

2In 2021 and 2020, our results were impacted by costs associated with our execution of programs to optimize our organization and cost structure. These actions included streamlining our international operations,
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rationalizing our manufacturing facilities, reducing our general and administrative infrastructure, re-aligning certain R&D activities and cancelling certain R&D programs. Our results in 2021 included business optimization charges of $18 million in the second quarter and $45 million in the first half. Our results in 2020 included business optimization charges of $13 million in the second quarter and $45 million in the first half. Additionally, we recognized a gain of $17 million in the first half of 2020 for property we sold in conjunction with our business optimization initiatives. Refer to Note 10 in Item 1 of this Quarterly Report on Form 10-Q for further information regarding these charges and related liabilities.

3Our results in 2021 included $1 million in the second quarter and $2 million in the first half of integration expenses related to our acquisition of the rights to Caelyx and Doxil for specified territories outside of the U.S. that was offset by a benefit of $5 million in the second quarter for the change in the estimated fair value of contingent consideration liabilities. Our results in 2020 included $9 million in the second quarter and $37 million in the first half of acquisition and integration expenses related to our acquisitions of Cheetah Medical Inc. (Cheetah), Seprafilm and in-process R&D assets, partially offset by the change in the estimated fair value of contingent consideration liabilities. Refer to Note 2 in Item 1 of this Quarterly Report on Form 10-Q for further information regarding business development activities.
4Our results in 2021 included $11 million in the second quarter and $19 million in the first half of costs related to updating our quality systems and product labeling to comply with the new medical device reporting regulation and other requirements of the European Union’s regulations for medical devices that become effective in stages beginning in 2021. Our results in 2020 included $8 million in the second quarter and $14 million in the first half of costs related to these requirements.
5Our results in 2021 included costs of $17 million in the second quarter and $28 million in the first half for investigation and related costs. Those costs primarily included charges related to matters associated with our previously announced investigation of foreign exchange gains and losses. Our results in 2020 included $2 million in the second quarter and $20 million in the first half for investigation and related costs. Those costs primarily included professional fees for the investigation and related matters, as well as incremental stock compensation expense as we extended the terms of certain stock options that were scheduled to expire in the first quarter of 2020. Refer to Notes 6 and 7 in Item 1 of this Quarterly Report on Form 10-Q for further information regarding the investigation and related legal charges and stock compensation expense.
6Our results in 2021 included a charge of $22 million related to an unfavorable court ruling for an uncertain tax position.
7Reflected in this item is the income tax impact of the special items identified in this table. The tax effect of each special item is based on the jurisdiction in which the item was incurred and the tax laws in effect for each such jurisdiction.
NET SALES
Three Months Ended June 30,Percent change
(in millions)20212020At actual
currency rates
At constant currency rates
United States$1,198 $1,127 %%
International$1,900 1,591 19 %10 %
Total net sales$3,098 $2,718 14 %%
Six Months Ended June 30,Percent change
(in millions)20212020At actual
currency rates
At constant currency rates
United States$2,378 $2,344 %%
International$3,666 3,176 15 %%
Total net sales$6,044 $5,520 %%
Foreign currency favorably impacted net sales by 5 and 4 percentage points, respectively, during the second quarter and first half of 2021 compared to the prior-year periods principally due to the weakening of the U.S. Dollar relative to the Euro, Australian Dollar, British Pound, Chinese Renminbi and Canadian Dollar.
The comparisons presented at constant currency rates reflect local currency sales at the prior period’s foreign exchange rates. This measure provides information on the change in net sales assuming that foreign currency
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exchange rates had not changed between the prior and the current period. We believe that the non-GAAP measure of change in net sales at constant currency rates, when used in conjunction with the U.S. GAAP measure of change in net sales at actual currency rates, may provide a more complete understanding and facilitate a fuller analysis of our results of operations, particularly in evaluating performance from one period to another.
Our global operations expose us to risks associated with public health crises and epidemics/pandemics, such as the COVID-19 pandemic. COVID-19 has had, and we expect will continue to have, an adverse impact on our operations, supply chains and distribution systems and has increased and we expect will continue to increase our expenses, including as a result of impacts associated with preventive and precautionary measures that we, other businesses and governments are taking. These measures have led to unprecedented restrictions on, disruptions in, and other related impacts on businesses and personal activities. In addition to travel restrictions put in place in early 2020, governments have closed borders, imposed prolonged quarantines and may continue those measures or implement other restrictions and requirements in light of the continuing spread of the pandemic. We expect that these evolving restrictions and requirements will continue to have an adverse effect on our business. For further discussion, refer to the Product Category Net Sales Reporting section below and Item 1A. Risk Factors in our 2020 Annual Report.
Product Category Net Sales Reporting
Beginning in the first quarter of 2021, our product category net sales disclosures (previously referred to as global business units (GBUs)) separately present net sales from our BioPharma Solutions business, which was previously included within Other. Concurrent with that disaggregation of net sales from our BioPharma Solutions business, we have also allocated certain previously unallocated sales deductions from Other to various categories, primarily based on their respective net sales. Net sales for the second quarter and first half of 2020 have been recast to conform to the current period presentation.
Our product categories include the following:
•    Renal Care includes sales of our peritoneal dialysis (PD), hemodialysis (HD) and additional dialysis therapies and services.
•    Medication Delivery includes sales of our intravenous (IV) therapies, infusion pumps, administration sets and drug reconstitution devices.
•    Pharmaceuticals includes sales of our premixed and oncology drug platforms, inhaled anesthesia and critical care products and pharmacy compounding services.
•    Clinical Nutrition includes sales of our parenteral nutrition (PN) therapies and related products.
•    Advanced Surgery includes sales of our biological products and medical devices used in surgical procedures for hemostasis, tissue sealing and adhesion prevention.
•    Acute Therapies includes sales of our continuous renal replacement therapies (CRRT) and other organ support therapies focused in the intensive care unit (ICU).
•    BioPharma Solutions includes sales of contracted services we provide to various pharmaceutical and biopharmaceutical companies.
•    Other includes sales of other miscellaneous product and service offerings.
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The following is a summary of net sales by product category:
Three Months Ended June 30,Percent change
(in millions)20212020At actual currency ratesAt constant currency rates
Renal Care
$964 $919 %(0)%
Medication Delivery
697 605 15 %12 %
Pharmaceuticals
546 481 14 %%
Clinical Nutrition
237 216 10 %%
Advanced Surgery
256 168 52 %48 %
Acute Therapies
188 186 %(4)%
BioPharma Solutions183 116 58 %49 %
Other
27 27 %%
Total Baxter$3,098 $2,718 14 %%
Six months ended June 30,Percent change
(in millions)20212020At actual currency ratesAt constant currency rates
Renal Care
$1,886 $1,789 %%
Medication Delivery
1,349 1,283 %%
Pharmaceuticals
1,098 997 10 %%
Clinical Nutrition
471 433 %%
Advanced Surgery
473 392 21 %17 %
Acute Therapies
395 342 15 %10 %
BioPharma Solutions318 230 38 %30 %
Other
54 54 %%
Total Baxter$6,044 $5,520 %%
Renal Care net sales increased 5% in both the second quarter and first half of 2021, as compared to the prior-year periods driven by a 5% and 4%, respectively, positive impact from foreign exchange rate changes, as compared to the prior-year periods. Additionally, global patient growth in PD was offset by lower in-center HD sales.
Medication Delivery net sales increased 15% in the second quarter and 5% in the first half of 2021, as compared to the prior-year periods. The increase in the second quarter was due to a favorable comparison to the second quarter of 2020 which was more severely impacted from lower demand for our infusion systems and related IV administration sets and solutions due to lower hospital admission rates and a reduction in elective surgeries resulting from the COVID-19 pandemic. The increase in the first half of 2021 reflects that increase in the second quarter and was partially offset by lower demand for our infusion systems and related IV administration sets and solutions in the first quarter of 2021 due to the COVID-19 pandemic. Additionally, foreign exchange rates had a favorable impact on Medication Delivery net sales of 3% and 2%, respectively, in the second quarter and first half of 2021, as compared to the prior-year periods.
Pharmaceuticals net sales increased 14% in the second quarter and 10% in the first half of 2021, as compared to the prior-year periods. The increase in the second quarter and first half was driven by a 9% and 7%, respectively, positive impact from foreign exchange rate changes, as compared to the prior-year periods. Additionally, the acquisition of the rights to Caelyx and Doxil for specified territories outside of the U.S. contributed $28 million and $41 million of net sales during the second quarter and first half of 2021, respectively.
Clinical Nutrition net sales increased 10% in the second quarter and 9% in the first half of 2021, as compared to the prior-year periods. The increase in the second quarter and first half was driven by a 7% and 6%, respectively, positive impact from foreign exchange rate changes, as compared to the prior-year periods. Additionally, Clinical Nutrition net sales increased due to growth in the U.S. for our PN therapies and related products, partially offset by lower international sales of vitamins resulting from supply constraints.
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Advanced Surgery net sales increased 52% in the second quarter and 21% in the first half of 2021, as compared to the prior-year periods. The increase in the second quarter and first half was driven by a recovery in elective surgeries, as many had been previously postponed due to the COVID-19 pandemic, and a 4% positive impact from foreign exchange rates as compared to the prior-year periods. Additionally, the acquisition of Seprafilm in February of 2020 contributed $8 million of incremental sales in the first quarter of 2021.
Acute Therapies net sales increased 1% in the second quarter and 15% in the first half of 2021, as compared to the prior-year periods. The increase in the second quarter was due to a 5% positive impact from foreign exchange rate changes, as compared to the prior-year period, partially offset by an unfavorable comparison to 2020, which included a 41% increase in net sales compared to 2019 due to a significant increase in demand for our CRRT systems to treat acute kidney injury during the COVID-19 pandemic. The increase in the first half was driven by increased global demand in the first quarter of 2021 for our CRRT systems during the COVID-19 pandemic and a 5% positive impact from foreign exchange rate changes, as compared to the prior-year period.
BioPharma Solutions net sales increased 58% in the second quarter and 38% in the first half of 2021, as compared to the prior-year periods. The increase in the second quarter and first half was driven by manufacturing services and supply packaging related to the production of COVID-19 vaccines on behalf of multiple pharmaceutical companies and a 9% and 8%, respectively, positive impact from foreign exchange rate changes, as compared to the prior-year periods.
Gross Margin and Expense Ratios
Three months ended June 30,
2021% of net sales2020% of net sales$ change% change
Gross margin$1,233 39.8 %$1,038 38.2 %$195 18.8 %
SG&A$675 21.8 %$590 21.7 %$85 14.4 %
R&D$139 4.5 %$117 4.3 %$22 18.8 %
Six months ended June 30,
2021% of net sales2020% of net sales$ change% change
Gross margin$2,378 39.3 %$2,201 39.9 %$177 8.0 %
SG&A$1,302 21.5 %$1,218 22.1 %$84 6.9 %
R&D$267 4.4 %$263 4.8 %$1.5 %
Gross Margin
The gross margin ratio was 39.8% and 39.3% in the second quarter and first half of 2021, respectively. The special items identified above had an unfavorable impact of approximately 2.8 and 3.0 percentage points on the gross margin ratio in the second quarter and first half of 2021, respectively. The gross margin ratio was 38.2% and 39.9% in the second quarter and first half of 2020, respectively. The special items identified above had an unfavorable impact of approximately 3.4 and 3.1 percentage points on the gross margin ratio in the second quarter and first half of 2020, respectively. Refer to the Special Items caption above for additional detail.
Excluding the impact of the special items, the gross margin ratio increased in the second quarter but decreased in the first half of 2021 compared to the prior-year periods. The increase in the second quarter was due to a favorable product mix. The decrease in the first half of 2021 was due to higher manufacturing and supply chain costs resulting from the COVID-19 pandemic.
SG&A
The SG&A expenses ratio was 21.8% and 21.5% in the second quarter and first half of 2021, respectively. The special items identified above had an unfavorable impact of approximately 0.9 and 0.7 percentage points on the SG&A expenses ratio in the second quarter and first half of 2021, respectively. The SG&A expenses ratio was 21.7% and 22.1% in the second quarter and first half of 2020, respectively. The special items identified above had an unfavorable impact of approximately 0.5 and 1.0 percentage points on the SG&A expenses ratio in the second quarter and first half of 2020, respectively. Refer to the Special Items caption above for additional detail.
Excluding the impact of the special items, the SG&A expenses ratio decreased in the second quarter and first half of 2021 compared to the prior-year periods primarily due to actions we took to restructure our cost position and focus on
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expense management, reduced travel and related expenses due to the COVID-19 pandemic and the impact of favorable foreign exchange rates as compared to the prior-year periods. Those benefits were partially offset by higher bonus accruals under our annual employee incentive compensation plans.
R&D
The R&D expenses ratio was 4.5% and 4.4% in the second quarter and first half of 2021, respectively. The R&D expenses ratio was 4.3% and 4.8% in the second quarter and first half of 2020, respectively. The special items identified above had an unfavorable impact of approximately 0.0 and 0.4 percentage points on the R&D expenses ratio in the second quarter and first half of 2020, respectively. Refer to the Special Items caption above for additional detail.
Excluding the impact of the special items, the R&D expenses ratio increased in the second quarter and was flat in the first half of 2021 compared to the prior-year periods as a result of increased project-related expenditures and higher bonus accruals under our annual employee incentive compensation plans that were partially offset by the impact of favorable foreign exchange rates as compared to the prior-year periods.    
Business Optimization Items
In recent years, we have undertaken actions to transform our cost structure and enhance operational efficiency. These efforts include restructuring the organization, optimizing our manufacturing footprint, R&D operations and supply chain network, employing disciplined cost management, and centralizing and streamlining certain support functions. From the commencement of our business optimization actions in the second half of 2015 through June 30, 2021, we have incurred cumulative pre-tax costs of $1.2 billion related to these actions. The costs consisted primarily of employee termination costs, implementation costs, contract termination costs, asset impairments, and accelerated depreciation. We currently expect to incur additional pre-tax costs of approximately $16 million through the completion of the initiatives that are currently underway, primarily related to implementation costs. We continue to pursue cost savings initiatives and, to the extent further cost savings opportunities are identified, we may incur additional restructuring charges and costs to implement business optimization programs in future periods. The reductions in our cost base from these actions in the aggregate are expected to provide cumulative annual pre-tax savings of more than $1.2 billion once the remaining actions are complete. The savings from these actions will impact cost of sales, SG&A expenses, and R&D expenses. Approximately 99 percent of the expected annual pre-tax savings are expected to be realized by the end of 2021, with the remainder by the end of 2023.
Other Operating Income, Net
Other operating income, net was $5 million in the second quarter and first half of 2021 as a result of a change in the estimated fair value of contingent consideration liabilities. Other operating income, net was $20 million in the first half of 2020 as we recognized a $17 million gain on the sale of property in conjunction with our business optimization initiatives and a $3 million gain as a result of a change in the estimated fair value of contingent consideration liabilities.
In September 2013, we entered into an agreement with Celerity Pharmaceutical, LLC (Celerity) to develop certain acute care generic injectable premix and oncolytic products through regulatory approval. We transferred our rights in these products to Celerity and Celerity assumed ownership and responsibility for development of the products. We are obligated to purchase the individual product rights from Celerity if the products obtain regulatory approval. In December 2020, we entered into an agreement with a third party to divest one of the products that is currently being developed by Celerity if that product receives regulatory approval in the U.S. and/or European Union. If regulatory approval is obtained, we would incur a loss ranging from $30 million to $60 million for the difference between our purchase price and the divestiture proceeds in connection with that transaction.
Interest Expense, Net
Interest expense, net was $34 million and $68 million in the second quarter and first half of 2021, respectively, and $36 million and $57 million in the second quarter and first half of 2020. The decrease in the second quarter was primarily driven by lower interest expense as a result of refinancing $750 million of 3.75% senior notes with $650 million of 1.73% senior notes and cash on hand in the fourth quarter of 2020. The increase in the first half of 2021 was primarily driven by higher average debt outstanding and lower interest income due to lower interest rates.
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Other (Income) Expense, Net
Other (income) expense, net was income of $2 million and expense of $3 million in the second quarter and first half of 2021, respectively, and expense of $6 million and $16 million in the second quarter and first half of 2020, respectively. Results in the second quarter and first half of 2021 were driven by an unrealized gain recognized in the second quarter of 2021 on a marketable equity security that was offset by foreign exchange net losses and pension and OPEB plan net expenses. Results in the second quarter and first half of 2020 were driven primarily by foreign exchange net losses.
In the first quarter of 2021, we began to wind down our operations in Argentina. Upon substantial liquidation of those operations in the future, we expect to reclassify currency translation adjustments (CTA) from accumulated other comprehensive (loss) income to other (income) expense, net and recognize a non-cash charge. As of June 30, 2021, the CTA for our Argentina operations was in excess of $60 million.
Income Taxes
Our effective income tax rate was 23.2% and 14.5% in the second quarter and 19.1% and 13.0% in the first half of 2021 and 2020, respectively. Our effective income tax rate can differ from the 21% U.S. federal statutory rate due to a number of factors, including foreign rate differences, tax incentives, increases or decreases in valuation allowances and liabilities for uncertain tax positions and excess tax benefits on stock compensation awards.
For the three months ended June 30, 2021, the difference between our effective income tax rate and the U.S. federal statutory rate was primarily attributable to an unfavorable court decision in a foreign jurisdiction related to an uncertain tax position.
For the six months ended June 30, 2021, the difference between our effective income tax rate and the U.S. federal statutory rate was primarily attributable to a favorable geographic earnings mix and decreases in accrued withholding taxes in several foreign jurisdictions, partially offset by an unfavorable court decision in a foreign jurisdiction related to an uncertain tax position.
For the three and six months ended June 30, 2020, the difference between our effective income tax rate and the U.S. federal statutory rate was primarily attributable to a favorable geographic earnings mix and excess tax benefits on stock compensation awards.
Segment Results
We use net sales and operating income on a segment basis to make resource allocation decisions and assess the ongoing performance of our segments. In the first quarter of 2021, the information provided to our Chief Executive Officer for purposes of allocating resources and assessing performance was updated to reallocate contracted services activities performed at a German manufacturing facility from our EMEA segment to our Americas segment. The contracted services performed at that facility are part of our BioPharma Solutions business, which is managed as part of the Americas segment. Accordingly, the reported financial results of the Americas segment now include the contracted services activities performed at that facility. Segment results for the second quarter and first half of 2020 have been recast to conform to the current period presentation. The following is a summary of financial information for our reportable segments:
Net salesOperating income (loss)
Three months ended June 30,Six months ended June 30,Three months ended June 30,Six months ended June 30,
(in millions)20212020202120202021202020212020
Americas$1,624 $1,469 $3,184 $3,034 $632 $527 $1,231 $1,115 
EMEA783 669 1,521 1,357 159 121 294 238 
APAC691 580 1,339 1,129 152 143 290 271 
Total segments3,098 2,718 6,044 5,520 943 791 1,815 1,624 
Corporate and other— — — — (519)(460)(1,001)(884)
Total$3,098 $2,718 $6,044 $5,520 $424 $331 $814 $740 
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Americas
Segment net sales and operating income were $1.6 billion and $632 million, respectively, in the second quarter and $3.2 billion and $1.2 billion, respectively, in the first half of 2021. Segment net sales and operating income were $1.5 billion and $527 million, respectively, in the second quarter and $3.0 billion and $1.1 billion, respectively, in the first half of 2020. The increase in operating profit in the second quarter and first half of 2021 was due to favorable sales performance in our Advanced Surgery, BioPharma Solutions and Medication Delivery product categories, partially offset by unfavorable performance in Pharmaceuticals.
EMEA
Segment net sales and operating income were $783 million and $159 million, respectively, in the second quarter and $1.5 billion and $294 million, respectively, in the first half of 2021. Segment net sales and operating income were $669 million and $121 million, respectively, in the second quarter and $1.4 billion and $238 million, respectively, in the first half of 2020. The increase in operating profit in the second quarter and first half of 2021 was due to the favorable impact of foreign exchange rates on results in the second quarter and first half of 2021 as compared to the prior-year periods and the acquisition of the rights to Caelyx and Doxil for specified territories outside of the U.S., which contributed $23 million and $33 million of net sales and operating profit to the region during the second quarter and first half of 2021, respectively.
APAC
Segment net sales and operating income were $691 million and $152 million, respectively, in the second quarter and $1.3 billion and $290 million, respectively, in the first half of 2021. Segment net sales and operating income were $580 million and $143 million, respectively, in the second quarter and $1.1 billion and $271 million, respectively, in the first half of 2020. The increase in operating profit in the second quarter and first half of 2021 was due to the favorable impact of foreign exchange rates on results in the second quarter and first half of 2021 as compared to 2020 and the acquisition of the rights to Caelyx and Doxil for specified territories outside of the U.S., which contributed $5 million and $7 million of net sales and operating profit to the region during the second quarter and first half of 2021, respectively.
Corporate and Other
Certain items are maintained at Corporate and are not allocated to a segment. They primarily include corporate headquarters costs, certain R&D costs, certain product category support costs, stock compensation expense, certain employee benefit plan costs, certain foreign currency hedging activities, and certain gains, losses, and other charges (such as business optimization, acquisition and integration costs, intangible asset amortization and asset impairments). The operating loss in the second quarter and first half of 2021 was higher than the prior-year periods primarily due to higher intangible asset amortization expense and higher bonus accruals under our annual employee incentive compensation plans in the current year that were partially offset by higher acquisition and integration expenses in the prior year.
LIQUIDITY AND CAPITAL RESOURCES
The following table is a summary of the statement of cash flows for the six-month periods ended June 30, 2021 and 2020.
Six months ended June 30,
(in millions)20212020
Cash flows from operations - continuing operations$854 $648 
Cash flows from investing activities(726)(758)
Cash flows from financing activities(707)909 
Cash Flows from Operations — Continuing Operations
In the first half of 2021, cash provided by operating activities was $854 million, as compared to cash provided by operating activities of $648 million in the first half of 2020, an increase of $206 million. The increase was primarily due to a lower increase in inventories in 2021 compared to 2020, an increase in our operating income in 2021 and lower employee incentive compensation payments in 2021 compared to 2020.
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Cash Flows from Investing Activities
In the first half of 2021, cash used for investing activities included payments for acquisitions and investments of $417 million, primarily related to Caelyx and Doxil and Transderm Scop, and capital expenditures of $329 million. In the first half of 2020, cash used for investing activities included payments for acquisitions and investments of $453 million, primarily related to Seprafilm and rights to multiple products we acquired, and capital expenditures of $316 million.
In July 2021, we acquired certain assets related to PerClot Polysaccharide Hemostatic System (PerClot), including distribution rights for the U.S. and specified territories outside of the U.S., from CryoLife, Inc. for an upfront purchase price of $25 million and the potential for additional cash consideration of up to $36 million based upon regulatory and commercial milestones.
Cash Flows from Financing Activities
In the first half of 2021, cash used in financing activities included payments for treasury stock repurchases of $565 million and dividend payments of $249 million, partially offset by stock issued under employee benefit plans of $93 million and the proceeds from commercial paper borrowings of $50 million. In the first half of 2020, cash generated from financing activities included $1.2 billion of net proceeds from the issuance of senior notes. Cash flows from financing activities in the six months ended June 30, 2020 also included receipts from stock issued under employee benefit plans of $151 million, repayments of borrowings under our Euro-denominated credit facility of €200 million ($225 million) and dividend payments of $223 million.
In July 2021, Baxter redeemed $400 million in 1.7% Senior Notes due August 2021, which was partially funded by the issuance of commercial paper.
As authorized by the Board of Directors, we repurchase our stock depending upon our cash flows, net debt levels and market conditions. In July 2012, the Board of Directors authorized the repurchase of up to $2.0 billion of our common stock. The Board of Directors increased this authority by an additional $1.5 billion in each of November 2016 and February 2018, by an additional $2.0 billion in November 2018 and by an additional $1.5 billion in October 2020. We paid $565 million in cash to repurchase approximately 7.3 million shares under this authority pursuant to Rule 10b5-1 plans in the first six months of 2021 and recognized a liability within accrued expenses and other current liabilities of $35 million for share repurchases that settled in July 2021. We had $1.3 billion remaining available under this authorization as of June 30, 2021.
Credit Facilities and Access to Capital and Credit Ratings
Credit Facilities
As of June 30, 2021, our U.S. dollar-denominated revolving credit facility and Euro-denominated senior revolving credit facility had a maximum capacity of $2.0 billion and €200 million, respectively. There were no borrowings outstanding under our U.S. dollar-denominated and Euro-denominated credit facilities as of June 30, 2021 or December 31, 2020. As of June 30, 2021, we were in compliance with the financial covenants in these agreements. The non-performance of any financial institution supporting either of the credit facilities would reduce the maximum capacity of these facilities by the institution’s respective commitment.
Access to Capital and Credit Ratings
We intend to fund short-term and long-term obligations as they mature through cash on hand, future cash flows from operations or by issuing additional debt. We had $3.1 billion of cash and cash equivalents as of June 30, 2021, with adequate cash available to meet operating requirements in each jurisdiction in which we operate. We invest our excess cash in money market and other funds and diversify the concentration of cash among different financial institutions. As of June 30, 2021, we had approximately $6.2 billion of long-term debt and finance lease obligations, including current maturities, and short-term debt. Subject to market conditions, we regularly evaluate opportunities with respect to our capital structure.
Our ability to generate cash flows from operations, issue debt or enter into other financing arrangements on acceptable terms could be adversely affected if there is a material decline in the demand for our products or in the solvency of our customers or suppliers, deterioration in our key financial ratios or credit ratings or other significantly unfavorable changes in conditions. However, we believe we have sufficient financial flexibility to issue debt, enter into other financing arrangements and attract long-term capital on acceptable terms to support our growth objectives. There have been no changes to our investment grade credit ratings that we disclosed in our 2020 Annual Report.
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In 2017, the United Kingdom’s Financial Conduct Authority announced that after 2021 it would no longer compel banks to submit the rates required to calculate the London Interbank Offered Rate (LIBOR) and other interbank offered rates, which have been widely used as reference rates for various securities and financial contracts, including loans, debt and derivatives. This announcement indicates that the continuation of LIBOR on the current basis was not guaranteed after 2021. Regulators in the U.S. and other jurisdictions have been working to replace these rates with alternative reference interest rates that are supported by transactions in liquid and observable markets, such as the Secured Overnight Financing Rate (SOFR). In 2020, it was announced that certain U.S. dollar LIBOR tenors would not cease until 2023. Currently, our credit facilities reference LIBOR-based rates. The discontinuation of LIBOR will require these arrangements to be modified in order to replace LIBOR with an alternative reference interest rate, which could impact our cost of funds. Our credit facilities include a provision specifying that we and the lenders will negotiate in good faith for the determination of a successor LIBOR rate.

CRITICAL ACCOUNTING POLICIES
The preparation of financial statements in accordance with U.S. GAAP requires management to make estimates and judgments that affect the reported amounts of assets, liabilities, revenues and expenses. A summary of our significant accounting policies is included in Note 1 to our consolidated financial statements in our 2020 Annual Report. Certain of our accounting policies are considered critical, as these policies are the most important to the depiction of our financial statements and require significant, difficult or complex judgments, often employing the use of estimates about the effects of matters that are inherently uncertain. Such policies are summarized in the Management’s Discussion and Analysis of Financial Condition and Results of Operations section in our 2020 Annual Report. There have been no significant changes in the application of our critical accounting policies during the first six months of 2021.
RECENT ACCOUNTING PRONOUNCEMENTS
There are no accounting standards issued but not yet effective that we believe will have a material impact on our condensed consolidated financial statements.
LEGAL CONTINGENCIES
Refer to Note 6 within Item 1 for a discussion of our legal contingencies. Upon resolution of any of these uncertainties, we may incur charges in excess of presently established liabilities. While our liability in connection with certain claims cannot be estimated with any certainty, and although the resolution in any reporting period of one or more of these matters could have a significant impact on our results of operations and cash flows for that period, the outcome of these legal proceedings is not expected to have a material adverse effect on our consolidated financial position. While we believe that we have valid defenses in these matters, litigation is inherently uncertain, excessive verdicts do occur, and we may in the future incur material judgments or enter into material settlements of claims.
CERTAIN REGULATORY MATTERS
Immediately prior to the closing of our acquisition of Claris Injectables Limited (Claris), the U.S. Food and Drug Administration (FDA) commenced an inspection of Claris’ facilities in Ahmedabad, India in July 2017. FDA completed the inspection and subsequently issued a Warning Letter based on observations identified in the 2017 inspection (Claris Warning Letter).1 FDA has not yet re-inspected the facilities and management cannot speculate on when the Claris Warning Letter will be lifted. However, we are continuing to implement corrective and preventive actions to address FDA’s prior observations and other items we identified and management continues to pursue and implement other manufacturing locations, including contract manufacturing organizations, to support the production of new products for distribution in the U.S. As of December 31, 2020, we have secured alternative locations to produce a majority of the planned new products to be manufactured in Ahmedabad for distribution into the U.S.
1 Available online at https://www.fda.gov/ICECI/EnforcementActions/WarningLetters/ucm613538.htm
FORWARD-LOOKING INFORMATION
This quarterly report on Form 10-Q includes forward-looking statements. Use of the words “may,” “will,” “would,” “could,” “should,” “believes,” “estimates,” “projects,” “potential,” “expects,” “plans,” “seeks,” “intends,” “evaluates,” “pursues,” “anticipates,” “continues,” “designs,” “impacts,” “affects,” “forecasts,” “target,” “outlook,” “initiative,” “objective,” “designed,” “priorities,” “goal,” or the negative of those words or other similar expressions is intended to
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identify forward-looking statements that represent our current judgment about possible future events. These forward-looking statements may include statements with respect to accounting estimates and assumptions, impacts of the COVID-19 pandemic, litigation-related matters including outcomes, impacts of the internal investigation related to foreign exchange gains and losses, future regulatory filings and our R&D pipeline, strategic objectives, sales from new product offerings, credit exposure to foreign governments, potential developments with respect to credit ratings, investment of foreign earnings, estimates of liabilities including those related to uncertain tax positions, contingent payments, future pension plan contributions, costs, discount rates and rates of return, our exposure to financial market volatility and foreign currency and interest rate risks, potential tax liabilities associated with the separation of our biopharmaceuticals business from our medical products businesses, the impact of competition, future sales growth, business development activities (including the acquisitions of Cheetah , Seprafilm, certain outside of the U.S. (OUS) rights to Caelyx and Doxil, and full U.S. and specific OUS rights to Transderm Scop), business optimization initiatives, cost saving initiatives, future capital and R&D expenditures, future debt issuances, manufacturing expansion, the adequacy of credit facilities, tax provisions and reserves, the effective tax rate and all other statements that do not relate to historical facts.

These forward-looking statements are based on certain assumptions and analyses made in light of our experience and perception of historical trends, current conditions, and expected future developments as well as other factors that we believe are appropriate in the circumstances. While these statements represent our judgment on what the future may hold, and we believe these judgments are reasonable, these statements are not guarantees of any events or financial results. Whether actual future results and developments will conform to expectations and predictions is subject to a number of risks and uncertainties, including the following factors, many of which are beyond our control:
demand for and market acceptance risks for and competitive pressures related to new and existing products (including challenges with our ability to accurately predict these pressures and the resulting impact on customer inventory levels and the impact of reduced hospital admission rates and elective surgery volumes), and the impact of those products on quality and patient safety concerns;
product development risks, including satisfactory clinical performance, the ability to manufacture at appropriate scale, and the general unpredictability associated with the product development cycle;
our ability to finance and develop new products or enhancements on commercially acceptable terms or at all;
our ability to identify business development and growth opportunities and to successfully execute on business development strategies;
product quality or patient safety issues, leading to product recalls, withdrawals, launch delays, warning letters, import bans, sanctions, seizures, litigation, or declining sales;
the impact of global economic conditions (including potential trade wars) and continuing public health crises, pandemics and epidemics, such as the COVID-19 pandemic, including related resurgences, on us and our customers and suppliers, including foreign governments in countries in which we operate;
the continuity, availability and pricing of acceptable raw materials and component supply, and the related continuity of our manufacturing and distribution;
inability to create additional production capacity in a timely manner or the occurrence of other manufacturing, sterilization or supply difficulties (including as a result of natural disaster, public health crises and epidemics/pandemics, regulatory actions or otherwise);
breaches or failures of our information technology systems or products, including by cyber-attack, data leakage, unauthorized access or theft (as a result of increased remote working arrangements or otherwise);
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future actions of (or failures to act or delays in acting by) FDA, the European Medicines Agency or any other regulatory body or government authority (including the SEC, DOJ or the Attorney General of any State) that could delay, limit or suspend product development, manufacturing or sale or result in seizures, recalls, injunctions, monetary sanctions or criminal or civil liabilities, including the continued delay in lifting the warning letter at our Ahmedabad facility or proceedings related to the misstatements in previously reported non-operating income related to foreign exchange gains and losses;
developments that would require the correction of additional misstatements in our previously issued financial statements;
failures with respect to our quality, compliance or ethics programs;
future actions of third parties, including third-party payers, the impact of healthcare reform and its implementation, suspension, repeal, replacement, amendment, modification and other similar actions undertaken by the United States or foreign governments, including with respect to pricing, reimbursement, taxation and rebate policies; legislation, regulation and other governmental pressures in the United States or globally, including the cost of compliance and potential penalties for purported noncompliance thereof, all of which may affect pricing, reimbursement, taxation and rebate policies of government agencies and private payers or other elements of our business, including new or amended laws, rules and regulations (such as the California Consumer Privacy Act of 2018, the European Union’s General Data Protection Regulation and proposed regulatory changes of the U.S. Department of Health and Human Services in kidney health policy and reimbursement, which may substantially change the U.S. end stage renal disease market and demand for our peritoneal dialysis products, necessitating significant multi-year capital expenditures, which are difficult to estimate in advance);
the outcome of pending or future litigation, including the opioid litigation, ethylene oxide litigation and litigation related to the investigation of foreign exchange gains and losses;
failure to achieve our long-term financial improvement goals;
the impact of competitive products and pricing, including generic competition, drug reimportation and disruptive technologies;
global regulatory, trade and tax policies;
the ability to protect or enforce our owned or in-licensed patent or other proprietary rights (including trademarks, copyrights, trade secrets and know-how) or patents of third parties preventing or restricting our manufacture, sale or use of affected products or technology;
the impact of any goodwill or other intangible asset impairments on our operating results;
any failure by Baxalta or Shire to satisfy its obligations under the separation agreements, including the tax matters agreement, or that certain letter agreement entered into with Shire and Baxalta;
fluctuations in foreign exchange and interest rates;
any changes in law concerning the taxation of income (whether with respect to current or future tax reform), including income earned outside the United States and potential taxes associated with the Base Erosion and Anti-Abuse Tax;
actions by tax authorities in connection with ongoing tax audits;
loss of key employees or inability to identify and recruit new employees;
other factors identified elsewhere in this report and other filings with the SEC, including those factors described in Item 1A of our Annual Report on Form 10-K for the year ended December 31, 2020, all of which are available on our website.

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Actual results may differ materially from those projected in the forward-looking statements. We do not undertake to update our forward-looking statements.
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Item 3.    Quantitative and Qualitative Disclosures About Market Risk
Currency Risk
We are primarily exposed to foreign exchange risk with respect to revenues generated outside of the United States denominated in the Euro, British Pound, Chinese Renminbi, Korean Won, Australian Dollar, Canadian Dollar, Japanese Yen, Colombian Peso, Brazilian Real, Mexican Peso, Indian Rupee and Swedish Krona. We manage our foreign currency exposures on a consolidated basis, which allows us to net exposures and take advantage of any natural offsets. In addition, we use derivative and nonderivative financial instruments to further reduce the net exposure to foreign exchange. Gains and losses on the hedging instruments offset losses and gains on the hedged transactions and reduce the earnings and stockholders’ equity volatility relating to foreign exchange. However, we don't hedge our entire foreign exchange exposure and are still subject to earnings and stockholders' equity volatility relating to foreign exchange risk. Financial market and currency volatility may limit our ability to cost-effectively hedge these exposures.
We use options and forwards to hedge the foreign exchange risk to earnings relating to forecasted transactions and recognized assets and liabilities denominated in foreign currencies. The maximum term over which we have cash flow hedge contracts in place related to foreign exchange risk on forecasted transactions as of June 30, 2021 is 12 months. We also enter into derivative instruments to hedge foreign exchange risk on certain intra-company and third-party receivables and payables and debt denominated in foreign currencies.
As part of our risk-management program, we perform sensitivity analyses to assess potential changes in the fair value of our foreign exchange contracts relating to hypothetical and reasonably possible near-term movements in foreign exchange rates.
A sensitivity analysis of changes in the fair value of foreign exchange contracts outstanding as of June 30, 2021, while not predictive in nature, indicated that if the U.S. Dollar uniformly weakened by 10% against all currencies, the net pre-tax liability balance of $10 million with respect to those contracts would change by $45 million.
The sensitivity analysis model recalculates the fair value of the foreign exchange contracts outstanding as of June 30, 2021 by replacing the actual exchange rates as of June 30, 2021 with exchange rates that are 10% weaker compared to the actual exchange rates for each applicable currency. All other factors are held constant. These sensitivity analyses disregard the possibility that currency exchange rates can move in opposite directions and that gains from one currency may or may not be offset by losses from another currency. The analyses also disregard the offsetting change in value of the underlying hedged transactions and balances.
Our subsidiary in Argentina is reported using highly inflationary accounting effective July 1, 2018. Changes in the value of the Argentine Peso applied to our peso-denominated net monetary asset positions are recorded in income at the time of the change. As of June 30, 2021, our net monetary assets denominated in Argentine Pesos are not significant.
Interest Rate and Other Risks
Refer to the caption “Interest Rate and Other Risks” in the “Financial Instrument Market Risk” section of the 2020 Annual Report. There were no significant changes during the quarter ended June 30, 2021.
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Item 4.    Controls and Procedures
Evaluation of Disclosure Controls and Procedures
Our management, with the participation of our Chief Executive Officer and our Chief Financial Officer, has evaluated the effectiveness of our disclosure controls and procedures (as defined in Rules 13a-15(e) and 15d-15(e) under the Securities Exchange Act of 1934, as amended (the Exchange Act)) as of June 30, 2021. Based on that evaluation, our Chief Executive Officer and our Chief Financial Officer concluded that our disclosure controls and procedures were effective as of June 30, 2021.
Changes in Internal Control over Financial Reporting
There have been no changes in our internal control over financial reporting (as such term is defined in Rules 13a-15(f) and 15d-15(f) under the Exchange Act) during the quarter ended June 30, 2021 that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.
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PART II. OTHER INFORMATION
Item 1.    Legal Proceedings
The information in Part I, Item 1, Note 6 is incorporated herein by reference.
Item 1A. Risk Factors

We do not believe that there have been any material changes to the risk factors previously disclosed in our 2020 Annual Report.
Item 2.    Unregistered Sales of Equity Securities and Use of Proceeds
Period
Total number of shares purchased (1)
Average price paid per share
Total number of shares purchased as part of publicly announced program(1)
Approximate dollar value of shares that may yet be purchased under the program(1)
April 1, 2021 through April 30, 2021— $— — 
May 1, 2021 through May 31, 2021— $— — 
June 1, 2021 through June 30, 20213,665,800 $81.86 3,665,800 
Total3,665,800 $81.86 3,665,800 $1,297,133,409 

(1)In July 2012, we announced that our Board of Directors authorized us to repurchase up to $2.0 billion of our common stock on the open market or in private transactions. The Board of Directors increased this authority by an additional $1.5 billion in each of November 2016 and February 2018, by an additional $2.0 billion in November 2018 and by an additional $1.5 billion in October 2020. During the second quarter of 2021, we repurchased approximately 3.7 million shares for $300 million pursuant to this authority through a Rule 10b5-1 purchase plan. We had $1.3 billion remaining under this program as of June 30, 2021. This program does not have an expiration date.
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Item 6.    Exhibits
Exhibit Index:
Exhibit
Number
Description
C 10.1*
31.1*
31.2*
32.1*
32.2*
101.INS*XBRL Instance Document
101.SCH*XBRL Taxonomy Extension Schema Document
101.CAL*XBRL Taxonomy Extension Calculation Linkbase Document
101.LAB*XBRL Taxonomy Extension Label Linkbase Document
101.PRE*XBRL Taxonomy Extension Presentation Linkbase Document
101.DEF*XBRL Taxonomy Extension Definition Linkbase Document
_____________________________________
*    Filed herewith.
C     Management contract or compensatory plan or arrangement.
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Signature
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.
BAXTER INTERNATIONAL INC.
(Registrant)
Date: July 29, 2021
By:/s/ James K. Saccaro
James K. Saccaro
Executive Vice President and Chief Financial Officer
(duly authorized officer and principal financial officer)

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