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Consolidated Statements of Cash Flows (unaudited) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018
Cash flows from operating activities
Net loss	$ (113,902)	$ (28,782)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation and amortization	14,760	12,243
Change in valuation of deferred and contingent consideration	26,460	0
Unrealized gain on MRI investment	(129)	0
Non-cash interest expense	4,055	3,644
Loss on disposal of asset	(50)	0
Amortization of discounts on investments, net	(907)	(230)
Amortization of debt issuance costs	280	256
Share-based compensation expense	20,184	15,831
Unrealized foreign currency transaction gains, net	62	(764)
Changes in operating assets and liabilities:
Inventory	(852)	(3,393)
Prepaid expenses and other current assets	(7,250)	254
Trade receivables, net	(9,702)	(20,429)
Deposits and other assets	(9,656)	(419)
Accounts payable and accrued expenses	(7,546)	2,225
Other liabilities	8,651	485
Deferred revenue	2,511	3,204
Net cash used in operating activities	(72,931)	(15,875)
Cash flows from investing activities
Purchases of fixed assets	(4,851)	(1,187)
Purchases of equity investment in MRI	(4,000)	0
Purchases of marketable securities	(226,261)	(28,656)
Sale and redemption of marketable securities	58,424	35,939
Acquisition of product rights and licenses	11,981	0
Net cash used in (provided by) investing activities	(188,669)	6,096
Cash flows from financing activities
Proceeds from exercise of options	4,129	3,592
Net proceeds from public offerings	224,545	117,874
Repayments of Debt	1,667	0
Proceeds from shares issued under employee stock purchase plan	1,564	1,299
Net cash provided by financing activities	228,571	122,765
Effect of exchange rate changes on cash	(375)	(990)
Net (decrease) increase in cash and cash equivalents	(33,404)	111,996
Cash and cash equivalents, beginning of period	169,498	111,792
Cash and cash equivalents, end of period	136,094	223,788
Supplemental disclosure of cash information
Cash paid for interest	3,111	3,838
Cash paid for income taxes	1,013	758
Supplemental disclosure of non-cash investing and financing activity
Unrealized gain (loss) on marketable securities	898	(83)
Right-of-use assets obtained in exchange for lease obligations	11,643	0
Noncash or Part Noncash Acquisition, Intangible Assets Acquired	$ 8,269	$ 3,903

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