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Consolidated Statements of Cash Flows
$ in Thousands
 6 Months Ended
Jun. 30, 2022
USD ($)
Jun. 30, 2021
USD ($)
Cash flows from operating activities    
Net loss $ (278,813) $ (247,012)
Adjustments to reconcile net loss to net cash used in operating activities:    
Depreciation and amortization 55,494 28,573
Non-cash operating lease expense 4,295 3,666
Non-cash royalty revenue related to sale of future royalties (17,482) (8,681)
Non-cash interest expense on liability related to sale of future royalties 37,825 38,083
Change in valuation of deferred and contingent consideration (26,900) 800
Unrealized gain on ClearPoint Equity Investments (2,369) (4,110)
Unrealized gain on ClearPoint convertible debt security (1,995) (4,326)
Unrealized gain on marketable securities - equity investments 11,356 (694)
Loss on disposal of asset 82  
Amortization of premiums on investments, net 1,540 2,644
Amortization of debt issuance costs 935 911
Share-based compensation expense 54,319 51,406
Unrealized foreign currency transaction losses, net 36,359 15,983
Changes in operating assets and liabilities:    
Inventory, net 27 1,906
Prepaid expenses and other current assets 16,431 15,649
Trade and royalty receivables, net (29,549) (9,420)
Deposits and other assets (974) (289)
Accounts payable and accrued expenses (9,060) (9,223)
Other liabilities (4,167) (3,083)
Deferred revenue   (4,085)
Net cash used in operating activities (152,646) (131,302)
Cash flows from investing activities    
Purchases of fixed assets (18,012) (13,643)
Purchases of marketable securities - available for sale (40,429) (192,931)
Purchases of marketable securities - equity investments   (200,000)
Sale and redemption of marketable securities- available for sale 257,534 514,716
Sale and redemption of marketable securities - equity investments 3,630  
Acquisition of product rights and licenses (81,426) (21,838)
Purchase of equity investment in ClearPoint   (100)
Net cash provided by investing activities 121,297 86,204
Cash flows from financing activities    
Proceeds from exercise of options 3,198 13,144
Proceeds from employee stock purchase plan 3,107 2,627
Payment of finance lease principal (1,276) (2,224)
Net cash provided by financing activities 5,029 13,547
Effect of exchange rate changes on cash 3,347 86
Net decrease in cash and cash equivalents (22,973) (31,465)
Cash and cash equivalents, and restricted cash beginning of period 197,218 216,312
Cash and cash equivalents, and restricted cash end of period 174,245 184,847
Supplemental disclosure of cash information    
Cash paid for interest 8,273 5,182
Cash paid for income taxes 2,949 4,127
Supplemental disclosure of non-cash investing and financing activity    
Unrealized loss on marketable securities, net of tax (3,069) (1,369)
Right-of-use assets obtained in exchange for operating lease obligations 68,642 13
Acquisition of product rights and licenses 26,687 $ 18,369
Milestone payable $ 50,000