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Consolidated Statements of Cash Flows (unaudited) - USD ($)
$ in Thousands
 6 Months Ended
Jun. 30, 2020
Jun. 30, 2019
Cash flows from operating activities    
Net loss $ (294,114) $ (113,902)
Adjustments to Reconcile Net Income (Loss) to Cash Provided by (Used in) Operating Activities [Abstract]    
Depreciation and amortization 19,445 14,760
Non-cash operating lease expense 2,401 1,256
Non-cash finance lease amortization expense 41,212 0
Change in valuation of deferred and contingent consideration 8,580 26,460
Settlement of deferred and contingent consideration 10,613 0
Non-cash stock consideration, acquisition 42,869 0
Unrealized loss on equity investment 1,600 (129)
Unrealized loss on ClearPoint convertible debt security 749 0
Non-cash interest expense 10,993 4,055
Loss on disposal of asset 26 50
Amortization of discounts on investments, net (635) (907)
Amortization of debt issuance costs 510 280
Amortization of discounts on investments, net 32,130 20,184
Unrealized foreign currency transaction (gains) losses, net (3,248) 62
Increase (Decrease) in Operating Capital [Abstract]    
Inventory, net 943 (852)
Prepaid expenses and other current assets (16,569) (7,250)
Trade receivables, net 1,860 (9,702)
Deposits and other assets (175) (9,656)
Accounts payable and accrued expenses (7,497) (7,546)
Other long-term liabilities (4,132) 7,395
Deferred revenue (3,925) 2,511
Net cash used in operating activities (156,364) (72,931)
Cash flows from investing activities    
Purchases of fixed assets (8,183) (4,851)
Purchase of convertible debt security (10,000) 0
Purchases of marketable securities (367,102) (226,261)
Sale and redemption of marketable securities 428,490 58,424
Acquisition of product rights and licenses (2,422) (11,981)
Purchase of equity investment 0 (4,000)
Net cash provided by (used in) investing activities 40,783 (188,669)
Cash flows from financing activities    
Proceeds from exercise of options 25,045 4,129
Net proceeds from public offerings 18,950 224,545
Repayment of senior secured term loan (10,000) (1,667)
Payments on deferred consideration obligation (35,829) 0
Proceeds from employee stock purchase plan 2,406 1,564
Payment of finance lease principal (15,000) 0
Net cash provided by financing activities (14,428) 228,571
Effect of exchange rate changes on cash 442 (375)
Net decrease in cash and cash equivalents (129,567) (33,404)
Cash and cash equivalents, and restricted cash beginning of period 295,528 169,498
Cash and cash equivalents, and restricted cash end of period 158,461  
Supplemental disclosure of cash information    
Cash paid for interest 5,286 3,111
Cash paid for income taxes 1,140 1,013
Supplemental disclosure of non-cash investing and financing activity    
Unrealized gain on marketable securities, net of tax 2,655 898
Right-of-use assets obtained in exchange for operating lease obligations 18,117 11,643
Right-of-use assets obtained in exchange for finance lease obligations 41,212 0
Acquisition of product rights and licenses 12,186 8,269
Issuance of common stock related to rights exchange $ 150,528 $ 0