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Consolidated Statements of Cash Flows (unaudited) - USD ($)
$ in Thousands
 6 Months Ended
Jun. 30, 2024
Jun. 30, 2023
Operating activities    
Net loss $ (457,700) $ (404,573)
Adjustments to reconcile net loss to net cash used in operating activities:    
Depreciation 3,024 2,559
Amortization of intangible assets 2,526 2,526
Stock-based compensation expense 44,736 34,802
Amortization of debt issuance costs 3,651 3,728
Paid-in-kind interest capitalized 12,571 11,201
Royalty financing non-cash interest expense 9,715 3,846
Accretion of discount on marketable securities, net (1,963) 0
Finance lease amortization expense 1,356 1,356
Non-cash operating lease expense 1,611 7,299
Change in fair value of deferred and contingent consideration liabilities 91,800 4,000
Change in fair value of interest rate swap (2,746) 349
Changes in operating assets and liabilities:    
Accounts receivable (1,080) (2,291)
Inventory (8,353) (8,081)
Prepaid expenses and other current assets (17,823) (155)
Other assets 15,699 (7,458)
Accounts payable and accrued liabilities 2,737 224
Other liabilities (6,748) (5,158)
Net cash used in operating activities (306,987) (269,095)
Investing activities    
Purchase of fixed assets (11,462) (8,281)
Purchase of marketable securities 0 (292,690)
Cash acquired in asset acquisition 0 3,417
Maturities of marketable securities 300,000 65,000
Net cash provided by (used in) investing activities 288,538 (232,554)
Financing activities    
Proceeds from exercise of stock options and ESPP 72,623 8,422
Proceeds from issuance of common stock, net 713,158 38,014
Payments of finance lease principal (1,266) (1,291)
Payment of debt issuance costs 0 (1,218)
Net cash provided by financing activities 784,515 43,927
Effect of exchange rates on cash and cash equivalents (1,641) (3,432)
Net increase (decrease) in cash and cash equivalents 764,425 (461,154)
Cash and cash equivalents at beginning of period 482,374 1,074,036
Cash and cash equivalents at end of period 1,246,799 612,882
Supplemental disclosures of cash flow information:    
Cash paid for interest 16,695 19,491
Cash paid for income taxes 1,562 1,362
Vertuis Bio, Inc.    
Adjustments to reconcile net loss to net cash used in operating activities:    
Vertuis acquisition 0 10,250
Adrestia acquisition 0 10,250
Adrestia Therapeutics Ltd    
Adjustments to reconcile net loss to net cash used in operating activities:    
Vertuis acquisition 0 76,481
Adrestia acquisition $ 0 $ 76,481