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Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2021
Dec. 31, 2020
Dec. 31, 2019
Cash flows from operating activities      
Net loss $ (523,901) $ (438,160) $ (251,576)
Adjustments to reconcile net loss to net cash used in operating activities:      
Depreciation and amortization 64,134 43,490 32,180
Non-cash operating lease expense 7,386 6,084 3,709
Non-cash finance lease amortization expense   41,382  
Non-cash royalty revenue related to sale of future royalties (23,460) (2,055)  
Non-cash interest expense on liability related to sale of future royalties 77,683 31,817  
Change in valuation of deferred and contingent consideration (500) 23,280 48,360
Settlement of deferred and contingent consideration   10,613  
Non-cash stock consideration, acquisition   42,869  
Unrealized loss (gain) on ClearPoint Equity Investments 6,078 (14,310) (2,194)
Unrealized loss (gain) on ClearPoint convertible debt security 8,281 (19,252)  
Unrealized gain on marketable securities - equity investments (1,673)    
Amortization of premiums (discounts) on investments, net 5,299 409 (1,922)
Amortization of debt issuance costs 1,848 1,020 694
Share-based compensation expense 103,513 70,325 42,134
Non-cash interest expense   22,598 12,027
Disposal of asset   16 312
Deferred income taxes 377 5,872 8,829
Unrealized foreign currency transaction losses (gains), net 47,391 (56,980) (11,619)
Changes in operating assets and liabilities:      
Inventory, net 1,800 1,841 (3,456)
Prepaid expenses and other current assets (15,310) (12,621) (8,835)
Trade and royalty receivables, net (44,991) (10,483) 11,525
Deposits and other assets (232) (662) (484)
Accounts payable and accrued expenses 45,659 70,798 26,836
Other liabilities (6,704) (3,930) (3,771)
Deferred revenue (4,010) (8,032) (1,388)
Net cash used in operating activities (251,332) (194,071) (98,639)
Cash flows from investing activities      
Purchases of fixed assets (28,213) (17,843) (13,757)
Purchase of convertible debt security   (10,000)  
Purchases of marketable securities - available for sale (333,148) (1,439,665) (494,068)
Purchases of marketable securities - equity investments (210,018)    
Sale and redemption of marketable securities- available for sale 843,498 944,094 156,270
Sale and redemption of marketable securities - equity investments 4,281    
Acquisition of product rights and licenses (57,118) (38,134) (31,682)
Purchase of equity investment in ClearPoint (100)   (4,000)
Net cash provided by (used in) investing activities 219,182 (561,548) (387,237)
Cash flows from financing activities      
Proceeds from issuance of convertible notes     279,267
Proceeds from exercise of options 17,309 70,179 18,276
Termination and exit fees related to payoff of secured term loan   (597)  
Net proceeds from public offerings   28,092 323,756
Repayment of senior secured term loan   (28,333) (11,667)
Payments on deferred consideration obligation   (38,100)  
Proceeds from employee stock purchase plan 5,792 5,303 3,577
Payment of finance lease principal (2,224) (17,829)  
Cash consideration received from Royalty Purchase Agreement   650,000  
Net cash provided by financing activities 20,877 668,715 613,209
Effect of exchange rate changes on cash (7,821) 7,688 (1,303)
Net decrease in cash and cash equivalents (19,094) (79,216) 126,030
Cash and cash equivalents, and restricted cash beginning of period 216,312 295,528 169,498
Cash and cash equivalents, and restricted cash end of period 197,218 216,312 295,528
Supplemental disclosure of cash information      
Cash paid for interest 9,588 9,802 7,693
Cash paid for income taxes 7,708 26,397 2,109
Supplemental disclosure of non-cash investing and financing activity      
Unrealized (loss) gain on marketable securities, net of tax (2,502) 1,145 724
Right-of-use assets obtained in exchange for operating lease obligations 645 76,811 17,389
Right-of-use assets obtained in exchange for finance lease obligations   41,382  
Acquisition of product rights and licenses $ 22,294 14,191 $ 11,434
Issuance of common stock related to rights exchange   150,528  
Capital expenditures unpaid at the end of period   $ 1,060