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Fair value of financial instruments and marketable securities - Narrative (Details) - USD ($)	3 Months Ended	9 Months Ended		12 Months Ended
	Sep. 30, 2019	Sep. 30, 2019	Sep. 30, 2018	Dec. 31, 2018	May 31, 2019	Aug. 23, 2018	Aug. 31, 2015
Financial assets and liabilities measured at fair value on recurring basis
Realized gain (loss)		$ 0
Estimated fair value of deferred consideration payable	$ 19,300,000	19,300,000		$ 18,300,000
Deferred consideration payable	19,700,000	19,700,000		19,400,000
Unrealized Gain (Loss) on Investments		2,529,000	$ 0
Investment In MRI	6,500,000	6,500,000
3.00% Convertible senior notes due 2022 | Convertible debt
Financial assets and liabilities measured at fair value on recurring basis
Principal	150,000,000	150,000,000		150,000,000			$ 150,000,000.0
Interest rate ( as a percent )							3.00%
Fair value of convertible notes	156,400,000	156,400,000		146,600,000
1.50% Convertible senior notes due 2026 | Convertible debt
Financial assets and liabilities measured at fair value on recurring basis
Principal	$ 287,500,000	$ 287,500,000
Interest rate ( as a percent )	1.50%	1.50%
Fair value of convertible notes	$ 273,800,000	$ 273,800,000
Agilis
Financial assets and liabilities measured at fair value on recurring basis
Development milestone payments which the entity is obligated to pay				$ 40,000,000.0		$ 40,000,000.0
Estimated fair value of deferred consideration payable						$ 38,100,000
Agilis | Minimum
Financial assets and liabilities measured at fair value on recurring basis
Product sales	2.00%	2.00%		2.00%
Agilis | Maximum
Financial assets and liabilities measured at fair value on recurring basis
Product sales	6.00%	6.00%		6.00%
Development milestone payments which the entity is obligated to pay	$ 60,000,000.0	$ 60,000,000.0		$ 60,000,000.0
Priority review voucher amount		535,000,000.0		535,000,000.0
Net sales amount	150,000,000.0	150,000,000.0		150,000,000.0
Non-collaborative Arrangement Transactions | Agilis
Financial assets and liabilities measured at fair value on recurring basis
Development milestone payments which the entity is obligated to pay	40,000,000.0	40,000,000.0
Recurring basis | Total
Financial assets and liabilities measured at fair value on recurring basis
Estimated fair value of deferred consideration payable	39,000,000	39,000,000		$ 37,700,000
Common stock
Financial assets and liabilities measured at fair value on recurring basis
Shares owned					$ 4,000,000.0
Fair value of shares (in dollars per share)					$ 3.10
Unrealized Gain (Loss) on Investments	$ 2,400,000	$ 2,500,000

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