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Balance Sheet Components - Property and Equipment (Detail) - USD ($)
$ in Thousands
12 Months Ended
Dec. 31, 2018
Dec. 31, 2017
Dec. 31, 2016
Property, Plant and Equipment, Net [Abstract]      
Property and equipment $ 693,056 $ 484,601  
Less: Accumulated depreciation and amortization (171,727) (135,808)  
Property, plant and equipment, net 521,329 348,793  
Depreciation and amortization $ 54,700 37,700 $ 24,000
Clinical and manufacturing equipment      
Property, Plant and Equipment [Line Items]      
Property, Plant and Equipment, Useful Life 10 years    
Property, Plant and Equipment, Net [Abstract]      
Property and equipment $ 236,179 183,392  
Computer hardware      
Property, Plant and Equipment [Line Items]      
Property, Plant and Equipment, Useful Life 3 years    
Property, Plant and Equipment, Net [Abstract]      
Property and equipment $ 34,297 24,933  
Computer software      
Property, Plant and Equipment [Line Items]      
Property, Plant and Equipment, Useful Life 3 years    
Property, Plant and Equipment, Net [Abstract]      
Property and equipment $ 59,617 54,756  
Furniture and fixtures      
Property, Plant and Equipment [Line Items]      
Property, Plant and Equipment, Useful Life 5 years    
Property, Plant and Equipment, Net [Abstract]      
Property and equipment $ 33,436 16,271  
Leasehold improvements      
Property, Plant and Equipment, Net [Abstract]      
Property and equipment $ 77,168 37,756  
Building      
Property, Plant and Equipment [Line Items]      
Property, Plant and Equipment, Useful Life 20 years    
Property, Plant and Equipment, Net [Abstract]      
Property and equipment $ 139,315 63,887  
Land      
Property, Plant and Equipment, Net [Abstract]      
Property and equipment 17,630 17,630  
Construction in progress      
Property, Plant and Equipment, Net [Abstract]      
Property and equipment $ 95,414 $ 85,976