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Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
 6 Months Ended
Jun. 30, 2023
Jun. 30, 2022
Cash flows from operating activities    
Net Income (Loss) $ (337,842) $ (278,813)
Adjustments to reconcile net loss to net cash used in operating activities:    
Depreciation and amortization 93,830 55,494
Non-cash operating lease expense 5,674 4,295
Non-cash royalty revenue related to sale of future royalties (29,059) (17,482)
Non-cash interest expense on liability related to sale of future royalties 37,753 37,825
Intangible asset impairment 217,800  
Change in valuation of contingent consideration (126,500) (26,900)
Unrealized loss (gain) on ClearPoint Equity Investments 1,112 (2,369)
Unrealized loss (gain) on ClearPoint convertible debt security 1,539 (1,995)
Unrealized (gain) loss on marketable securities - equity investments (4,364) 11,356
Realized loss for the sale of Clearpoint Equity Investment 782  
Non-cash stock consideration, milestone payment 29,570  
Disposal of asset 133 82
Amortization of (discounts) premiums on investments, net (88) 1,540
Deferred income taxes (50,907)  
Amortization of debt issuance costs 1,001 935
Share-based compensation expense 58,186 54,319
Unrealized foreign currency transaction (gains) losses, net (13,332) 36,359
Changes in operating assets and liabilities:    
Inventory, net (9,795) 27
Prepaid expenses and other current assets 63,951 16,431
Trade and royalty receivables, net (18,022) (29,549)
Deposits and other assets 6,936 (974)
Accounts payable and accrued expenses 32,437 (9,060)
Other liabilities (3,055) (4,167)
Deferred revenue (1,351)  
Net cash used in operating activities (43,611) (152,646)
Cash flows from investing activities    
Purchases of fixed assets (16,515) (18,012)
Purchases of marketable securities - available for sale   (40,429)
Purchases of marketable securities - equity investments (18,159)  
Sale and redemption of marketable securities- available for sale 21,544 257,534
Sale and redemption of marketable securities - equity investments 4,249 3,630
Sale and redemption of ClearPoint Equity Investments 2,594  
Acquisition of product rights and licenses (46,436) (81,426)
Net cash (used in) provided by investing activities (52,723) 121,297
Cash flows from financing activities    
Proceeds from exercise of options 20,325 3,198
Debt issuance costs related to secured term loan (197)  
Proceeds from employee stock purchase plan 3,805 3,107
Payment of finance lease principal (1,379) (1,276)
Net cash provided by financing activities 22,554 5,029
Effect of exchange rate changes on cash 2,351 3,347
Net decrease in cash and cash equivalents (71,429) (22,973)
Cash and cash equivalents, and restricted cash beginning of period 295,925 197,218
Cash and cash equivalents, and restricted cash end of period 224,496 174,245
Supplemental disclosure of cash information    
Cash paid for interest 22,310 8,273
Cash paid for income taxes 9,196 2,949
Supplemental disclosure of non-cash investing and financing activity    
Unrealized gain (loss) on marketable securities, net of tax 451 (3,069)
Right-of-use assets obtained in exchange for operating lease obligations   68,642
Acquisition of product rights and licenses 36,879 26,687
Debt issuance costs related to senior secured term loan 38  
Capital expenditures unpaid at the end of period 36  
Milestone payable $ 2,500 $ 50,000