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Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
 3 Months Ended
Mar. 31, 2022
Mar. 31, 2021
Cash flows from operating activities    
Net loss $ (126,726) $ (128,642)
Adjustments to reconcile net loss to net cash used in operating activities:    
Depreciation and amortization 26,314 13,587
Non-cash operating lease expense 1,908 1,819
Non-cash royalty revenue related to sale of future royalties (8,113) (2,858)
Non-cash interest expense on liability related to sale of future royalties 18,874 18,080
Change in valuation of deferred and contingent consideration (11,700) 100
Unrealized loss (gain) on ClearPoint Equity Investments 1,049 (6,764)
Unrealized loss (gain) on ClearPoint convertible debt security 1,542 (7,858)
Unrealized gain on marketable securities - equity investments 6,477 302
Amortization of premiums on investments, net 887 1,359
Amortization of debt issuance costs 464 452
Share-based compensation expense 26,589 25,707
Disposal of asset 79  
Unrealized foreign currency transaction losses, net 2,135 24,691
Changes in operating assets and liabilities:    
Inventory, net 350 1,963
Prepaid expenses and other current assets 25,118 15,605
Trade and royalty receivables, net (28,372) (25,010)
Deposits and other assets (510) 136
Accounts payable and accrued expenses (30,680) (28,756)
Other liabilities (3,089) (1,916)
Deferred revenue   (2,154)
Net cash used in operating activities (97,404) (100,157)
Cash flows from investing activities    
Purchases of fixed assets (9,312) (5,669)
Purchases of marketable securities - available for sale (39,035) (141,985)
Purchases of marketable securities - equity investments   (200,000)
Sale and redemption of marketable securities- available for sale 167,101 392,093
Sale and redemption of marketable securities - equity investments 2,423  
Acquisition of product rights and licenses (72,134) (14,192)
Purchase of equity investment in ClearPoint   (100)
Net cash provided by investing activities 49,043 30,147
Cash flows from financing activities    
Proceeds from exercise of options 2,444 11,755
Payment of finance lease principal (1,276) (2,224)
Net cash provided by financing activities 1,168 9,531
Effect of exchange rate changes on cash 1,653 (1,701)
Net decrease in cash and cash equivalents (45,540) (62,180)
Cash and cash equivalents, and restricted cash beginning of period 197,218 216,312
Cash and cash equivalents, and restricted cash end of period 151,678 154,132
Supplemental disclosure of cash information    
Cash paid for interest 6,130 5,182
Cash paid for income taxes 1,987 687
Supplemental disclosure of non-cash investing and financing activity    
Unrealized loss on marketable securities, net of tax (2,913) (1,294)
Right-of-use assets obtained in exchange for operating lease obligations 587 13
Acquisition of product rights and licenses $ 12,589 $ 8,870