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Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
 9 Months Ended
Sep. 30, 2023
Sep. 30, 2022
Cash flows from operating activities    
Net Income (Loss) $ (470,812) $ (388,128)
Adjustments to reconcile net loss to net cash used in operating activities:    
Depreciation and amortization 155,885 89,971
Non-cash operating lease expense 8,156 7,505
Non-cash royalty revenue related to sale of future royalties (50,599) (31,617)
Non-cash interest expense on liability related to sale of future royalties 56,031 55,778
Intangible asset impairment 217,800  
Change in valuation of contingent consideration (125,000) (32,200)
Unrealized loss on ClearPoint Equity Investments 3,107 1,113
Unrealized loss on ClearPoint convertible debt security 4,594 2,392
Unrealized (gain) loss on marketable securities - equity investments (5,484) 11,319
Realized loss for the sale of Clearpoint Equity Investment 782  
Non-cash stock consideration, milestone payment 29,570  
Disposal of asset 135 81
Amortization of (discounts) premiums on investments, net (89) 1,792
Deferred income taxes (50,909)  
Amortization of debt issuance costs 1,574 1,316
Share-based compensation expense 85,128 82,989
Unrealized foreign currency transaction losses, net 3,394 71,246
Changes in operating assets and liabilities:    
Inventory, net (14,121) (768)
Prepaid expenses and other current assets 59,467 (35,615)
Trade and royalty receivables, net (9,887) (24,773)
Deposits and other assets 4,597 (3,752)
Accounts payable and accrued expenses 40,434 1,568
Other liabilities (1,756) (908)
Deferred revenue (127)  
Net cash used in operating activities (58,130) (190,691)
Cash flows from investing activities    
Purchases of fixed assets (22,872) (23,394)
Purchases of marketable securities - available for sale   (40,429)
Purchases of marketable securities - equity investments (26,378) (22,787)
Sale and redemption of marketable securities- available for sale 21,544 341,990
Sale and redemption of marketable securities - equity investments 12,078 104,431
Sale and redemption of ClearPoint Equity Investments 2,594  
Acquisition of product rights and licenses (69,285) (102,069)
Net cash (used in) provided by investing activities (82,319) 257,742
Cash flows from financing activities    
Proceeds from exercise of options 23,771 13,203
Debt issuance costs related to secured term loan (282)  
Repayment of Convertible Notes   (150,000)
Proceeds from employee stock purchase plan 3,805 3,107
Payment of finance lease principal (1,379) (1,276)
Net cash provided by (used in) financing activities 25,915 (134,966)
Effect of exchange rate changes on cash 19 (8,792)
Net decrease in cash and cash equivalents (114,515) (76,707)
Cash and cash equivalents, and restricted cash beginning of period 295,925 197,218
Cash and cash equivalents, and restricted cash end of period 181,410 120,511
Supplemental disclosure of cash information    
Cash paid for interest 34,020 12,679
Cash paid for income taxes 13,631 4,029
Supplemental disclosure of non-cash investing and financing activity    
Unrealized gain (loss) on marketable securities, net of tax 470 (2,333)
Right-of-use assets obtained in exchange for operating lease obligations   35,294
Acquisition of product rights and licenses 44,963 27,828
Milestone payable $ 2,500 $ 50,000