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Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Operating activities      
Net loss $ (749,567) $ (481,534) $ (434,654)
Adjustments to reconcile net loss to net cash used in operating activities:      
Depreciation 5,527 5,278 9,130
Amortization of intangible assets 5,052 5,053 5,052
Stock-based compensation expense 74,778 57,686 46,021
Loss on extinguishment of debt 0 0 17,689
Amortization of debt issuance costs 7,320 3,991 1,890
Accretion of debt discount 0 0 29,149
Paid-in-kind interest capitalized 23,372 4,165 0
Royalty Financing non-cash interest expense 18,846 3,687 0
Accretion of discount on marketable securities, net (9,383) 0 0
Finance lease amortization expense 2,712 1,960 1,078
Non-cash operating lease expense 9,206 11,976 12,589
Change in fair value of deferred and contingent consideration liabilities 28,697 (20,802) 7,334
Change in fair value of interest rate swap (320) 1,526 0
Changes in operating assets and liabilities:                    
Accounts receivable (11,963) (6,423) (8,118)
Inventory (13,613) (1,714) (17,456)
Prepaid expenses and other current assets 2,265 2,528 (5,549)
Other assets (20,074) (25,243) (24,435)
Accounts payable and accrued liabilities 15,155 50,011 (7,575)
Other liabilities (10,988) (12,584) 4,553
Net cash used in operating activities (536,247) (400,439) (363,302)
Investing activities      
Purchase of fixed assets (13,288) (9,878) (7,289)
Purchase of marketable securities (588,733) (99,706) (50,292)
Cash acquired in asset acquisition 3,417 0 0
Maturities of marketable securities 375,000 75,000 0
Cash paid for Business Acquisition, net 0 0 (6,704)
Net cash used in investing activities (223,604) (34,584) (64,285)
Financing activities      
Proceeds from exercise of stock options and ESPP 18,399 19,504 22,037
Proceeds from issuance of common stock, net               152,475 292,153 269,886
Payment on extinguishment of 1.75% convertible senior notes due 2025 0 0 (12,578)
Payment of principal of 1.75% convertible senior notes due 2025 0 0 (225,000)
Proceeds from issuance of 0.75% convertible senior notes due 2028 0 0 575,000
Proceeds from issuance of Term Loan 0 350,000 0
Proceeds from issuance Royalty Financing Agreement 0 150,000 0
Payment of debt issuance costs (1,218) (17,783) (15,718)
Payments of finance lease principal (1,217) (601) (1,081)
Net cash provided by financing activities               168,439 793,273 612,546
Effect of exchange rates on cash and cash equivalents (250) (996) (933)
Net (decrease) increase in cash and cash equivalents (591,662) 357,254 184,026
Cash and cash equivalents at beginning of period 1,074,036 716,782 532,756
Cash and cash equivalents at end of period 482,374 1,074,036 716,782
Supplemental disclosures of cash flow information:      
Cash paid for interest 35,787 10,157 10,890
Cash paid for income taxes 1,955 1,717 1,558
Vertuis Bio, Inc.      
Adjustments to reconcile net loss to net cash used in operating activities:      
Vertuis acquisition 10,250 0 0
Adrestia acquisition 10,250 0 0
Adrestia Therapeutics Ltd      
Adjustments to reconcile net loss to net cash used in operating activities:      
Vertuis acquisition 76,481 0 0
Adrestia acquisition $ 76,481 $ 0 $ 0