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Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
 3 Months Ended
Mar. 31, 2021
Mar. 31, 2020
Cash flows from operating activities    
Net loss $ (128,642) $ (112,687)
Adjustments to reconcile net loss to net cash used in operating activities:    
Depreciation and amortization 13,587 9,235
Non-cash operating lease expense 1,819 1,330
Non-cash royalty revenue related to sale of future royalties (2,858)  
Non-cash interest expense on liability related to sale of future royalties 18,080  
Change in valuation of deferred and contingent consideration 100 900
Unrealized (gain) loss on ClearPoint Equity Investments (6,764) 1,574
Unrealized (gain) loss on ClearPoint convertible debt security (7,858) 2,799
Unrealized loss on marketable securities - equity investments 302  
Amortization of premiums (discounts) on investments, net 1,359 (333)
Amortization of debt issuance costs 452 256
Share-based compensation expense 25,707 15,220
Non-cash interest expense   5,459
Unrealized foreign currency transaction gains, net 24,691 8,675
Changes in operating assets and liabilities:    
Inventory, net 1,963 102
Prepaid expenses and other current assets 15,605 (6,675)
Trade receivables, net (25,010) 2,346
Deposits and other assets 136 (192)
Accounts payable and accrued expenses (28,756) (4,000)
Other liabilities (1,916) (4,363)
Deferred revenue (2,154) (1,200)
Net cash used in operating activities (100,157) (81,554)
Cash flows from investing activities    
Purchases of fixed assets (5,669) (6,023)
Purchase of convertible debt security   (10,000)
Purchases of marketable securities - available for sale (141,985) (298,814)
Purchases of marketable securities - equity investments (200,000)  
Sale and redemption of marketable securities- available for sale 392,093 224,997
Acquisition of product rights and licenses (14,192) (11,434)
Purchase of equity investment in ClearPoint (100)  
Net cash provided by (used in) investing activities 30,147 (101,274)
Cash flows from financing activities    
Proceeds from exercise of options 11,755 9,987
Net proceeds from public offerings   13,503
Repayment of senior secured term loan   (5,000)
Payment of finance lease principal (2,224)  
Net cash provided by financing activities 9,531 18,490
Effect of exchange rate changes on cash (1,701) (403)
Net decrease in cash and cash equivalents (62,180) (164,741)
Cash and cash equivalents, and restricted cash beginning of period 216,312 295,528
Cash and cash equivalents, and restricted cash end of period 154,132 130,787
Supplemental disclosure of cash information    
Cash paid for interest 5,182 4,878
Cash paid for income taxes 687 507
Supplemental disclosure of non-cash investing and financing activity    
Unrealized loss on marketable securities, net of tax (1,294) (63)
Right-of-use assets obtained in exchange for operating lease obligations 13 22,642
Acquisition of product rights and licenses $ 8,870 $ 2,775