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Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Cash flows from operating activities      
Net loss $ (559,017) $ (523,901) $ (438,160)
Adjustments to reconcile net loss to net cash used in operating activities:      
Depreciation and amortization 128,836 64,134 43,490
Non-cash operating lease expense 9,884 7,386 6,084
Non-cash finance lease amortization expense     41,382
Non-cash royalty revenue related to sale of future royalties (48,738) (23,460) (2,055)
Non-cash interest expense on liability related to sale of future royalties 72,639 77,683 31,817
Intangible asset impairment 33,384    
Change in valuation of deferred and contingent consideration (25,900) (500) 23,280
Settlement of deferred and contingent consideration     10,613
Non-cash stock consideration, acquisition     42,869
Unrealized loss (gain) on ClearPoint Equity Investments 3,560 6,078 (14,310)
Unrealized loss (gain) on ClearPoint convertible debt security 5,740 8,281 (19,252)
Unrealized loss (gain) on marketable securities - equity investments 7,992 (1,673)  
Disposal of asset 80   16
Deferred income taxes (34,276) 377 5,872
Amortization of premiums on investments, net 1,713 5,299 409
Amortization of debt issuance costs 1,901 1,848 1,020
Share-based compensation expense 110,333 103,513 70,325
Non-cash interest expense     22,598
Unrealized foreign currency transaction losses, net 13,263 47,391 (56,980)
Non cash foreign currency remeasurement loss on intercompany loan 16,887    
Changes in operating assets and liabilities:      
Inventory, net (6,668) 1,800 1,841
Prepaid expenses and other current assets (51,621) (15,310) (12,621)
Trade and royalty receivables, net (48,468) (44,991) (10,483)
Deposits and other assets (2,913) (232) (662)
Accounts payable and accrued expenses 27,542 45,659 71,963
Other liabilities (4,558) (6,704) (3,930)
Deferred revenue 1,351 (4,010) (8,032)
Payments on contingent consideration (9,600)   (1,165)
Net cash used in operating activities (356,654) (251,332) (194,071)
Cash flows from investing activities      
Purchases of fixed assets (32,016) (28,213) (17,843)
Purchases of marketable securities - available for sale (52,764) (333,148) (1,439,665)
Purchase of convertible debt security     (10,000)
Purchases of marketable securities - equity investments (22,787) (210,018)  
Sale and redemption of marketable securities- available for sale 405,234 843,498 944,094
Sale and redemption of marketable securities - equity investments 112,958 4,281  
Acquisition of product rights and licenses (120,444) (57,118) (38,134)
Purchase of equity investment in ClearPoint   (100)  
Net cash provided by (used in) investing activities 290,181 219,182 (561,548)
Cash flows from financing activities      
Proceeds from exercise of options 14,632 17,309 70,179
Termination and exit fees related to payoff of secured term loan     (597)
Net proceeds from public offerings     28,092
Debt issuance costs related to secured term loan (11,454)    
Proceeds from issuance of senior secured term loan 300,000    
Repayment of Convertible Notes (150,000)   (28,333)
Payments on deferred and contingent consideration obligation (40,400)   (38,100)
Proceeds from employee stock purchase plan 6,450 5,792 5,303
Payment of finance lease principal (1,276) (2,224) (17,829)
Proceeds from stock purchase agreement 50,000    
Cash consideration received from Royalty Purchase Agreement     650,000
Net cash provided by financing activities 167,952 20,877 668,715
Effect of exchange rate changes on cash (2,772) (7,821) 7,688
Net decrease in cash and cash equivalents 98,707 (19,094) (79,216)
Cash and cash equivalents, and restricted cash beginning of period 197,218 216,312 295,528
Cash and cash equivalents, and restricted cash end of period 295,925 197,218 216,312
Supplemental disclosure of cash information      
Cash paid for interest 18,463 9,588 9,802
Cash paid for income taxes 4,922 7,708 26,397
Supplemental disclosure of non-cash investing and financing activity      
Unrealized gain (loss) on marketable securities, net of tax 108 (2,502) 1,145
Right-of-use assets obtained in exchange for operating lease obligations 35,817 645 76,811
Right-of-use assets obtained in exchange for finance lease obligations     41,382
Acquisition of product rights and licenses 33,239 $ 22,294 14,191
Issuance of common stock related to rights exchange     150,528
Debt issuance costs related to senior secured term loan 159    
Capital expenditures unpaid at the end of period $ 308   $ 1,060