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Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2019
Dec. 31, 2018
Dec. 31, 2017
Cash flows from operating activities      
Net loss $ (251,576) $ (128,081) $ (79,000)
Adjustments to reconcile net loss to net cash used in operating activities:      
Depreciation and amortization 32,180 26,087 17,682
Non-cash lease expense 3,709    
Change in the fair value of deferred and contingent consideration 48,360 19,340 0
Unrealized gain on equity investment (2,194) 0 0
Amortization of (discounts) premiums on investments, net (1,922) (433) 535
Amortization of debt issuance costs 694 524 433
Share-based compensation expense 42,134 33,252 30,559
Non-cash interest expense 12,027 7,518 6,755
Disposal of asset 312 2 5
Deferred income taxes 8,829 0 199
Unrealized foreign currency transaction gains, net (11,619) (59) (459)
Changes in operating assets and liabilities:      
Inventory, net (3,456) (5,823) (6,454)
Prepaid expenses and other current assets (8,835) (1,609) (1,784)
Trade receivables, net 11,525 (29,589) (12,203)
Deposits and other assets (17,923) (1,093) (544)
Accounts payable and accrued expenses 26,836 43,877 24,011
Other long-term liabilities 13,668 1,932 733
Deferred revenue (1,388) 6,514 9,469
Net cash used in operating activities (98,639) (27,641) (10,063)
Cash flows from investing activities      
Purchases of fixed assets (13,757) (7,097) (3,101)
Purchase of equity investment (4,000) 0 0
Purchases of marketable securities (494,068) (68,614) (81,368)
Sale & redemption of marketable securities 156,270 90,423 174,749
Acquisition of product rights (31,682) (8,433) (77,163)
Business acquisition, net of cash acquired 0 (48,892) 0
Net cash (used in) provided by investing activities (387,237) (42,613) 13,117
Cash flows from financing activities      
Proceeds from issuance of convertible notes 279,267 0 0
Proceeds from exercise of options 18,276 10,868 2,182
Proceeds from shares issued under employee stock purchase plan 3,577 2,787 2,468
Debt issuance costs related to secured term loan 0 0 (432)
Net proceeds from public offering 323,756 117,916 0
Proceeds from issuance of secured term loan 0 0 40,000
Repayment of senior secured term loan (11,667) 0 0
Net cash provided by financing activities 613,209 131,571 44,218
Effect of exchange rate changes on cash (1,303) (3,611) 6,199
Net increase in cash and cash equivalents 126,030 57,706 53,471
Cash and cash equivalents, beginning of period 169,498 111,792 58,321
Cash and cash equivalents, and restricted cash end of period 295,528 169,498 111,792
Supplemental disclosure of cash information      
Cash paid for interest 7,693 7,773 6,271
Cash paid for income taxes 2,109 1,583 1,101
Supplemental disclosures of non-cash information related to investing and financing activities      
Unrealized gain on marketable securities 724 9 225
Right-of-use assets obtained in exchange for lease obligations 17,389 0 0
Acquisition of product rights and licenses $ 11,434 $ 5,981 $ 0