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Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Cash flows from operating activities      
Net Income (Loss) $ (626,604) $ (559,017) $ (523,901)
Adjustments to reconcile net loss to net cash used in operating activities:      
Depreciation and amortization 236,590 128,836 64,134
Non-cash operating lease expense 9,827 9,884 7,386
Non-cash royalty revenue related to sale of future royalties (93,460) (48,738) (23,460)
Non-cash interest expense on liability related to sale of future royalties 104,790 72,639 77,683
Intangible asset impairment 217,800 33,384  
Change in valuation of contingent consideration (127,700) (25,900) (500)
Unrealized loss on ClearPoint Equity Investments 1,515 3,560 6,078
Unrealized loss on ClearPoint convertible debt security 2,678 5,740 8,281
Unrealized (gain) loss on marketable securities - equity investments (2,517) 7,992 (1,673)
Realized loss for the sale of Clearpoint Equity Investment 782    
Realized gain on redemption of marketable securities- equity investments (4,383)    
Non-cash stock consideration, milestone payment 29,570    
Disposal of asset 806 80  
Amortization of (discounts) premiums on investments, net (2,200) 1,713 5,299
Deferred income taxes (46,930) (34,276) 377
Amortization of debt issuance costs 1,873 1,901 1,848
Loss on extinguishment of debt 55,625    
Share-based compensation expense 101,636 110,333 103,513
Unrealized foreign currency transaction (gains) losses, net (14,113) 13,263 47,391
Non cash foreign currency remeasurement loss on intercompany loan   16,887  
Changes in operating assets and liabilities:      
Inventory, net (8,183) (6,668) 1,800
Prepaid expenses and other current assets (44,992) (51,621) (15,310)
Trade and royalty receivables, net (1,539) (48,468) (44,991)
Deposits and other assets 5,222 (2,913) (232)
Accounts payable and accrued expenses 48,346 27,542 45,659
Other liabilities (2,307) (4,558) (6,704)
Deferred revenue (550) 1,351 (4,010)
Payments on contingent consideration   (9,600)  
Net cash used in operating activities (158,418) (356,654) (251,332)
Cash flows from investing activities      
Purchases of fixed assets (28,438) (32,016) (28,213)
Purchases of marketable securities - available for sale (174,086) (52,764) (333,148)
Purchases of marketable securities - equity investments (38,398) (22,787) (210,018)
Sale and redemption of marketable securities- available for sale 21,544 405,234 843,498
Sale and redemption of marketable securities - equity investments 132,228 112,958 4,281
Sale and redemption of ClearPoint Equity Investments 2,594    
Acquisition of product rights and licenses (92,181) (120,444) (57,118)
Purchase of equity investment in ClearPoint     (100)
Net cash (used in) provided by investing activities (176,737) 290,181 219,182
Cash flows from financing activities      
Proceeds from exercise of options 24,040 14,632 17,309
Repayment of senior secured term loan (300,000)    
Debt extinguishment costs related to senior secured term loan (81,933)    
Cash consideration received from Royalty Purchase Agreement 1,000,000    
Debt issuance costs related to secured term loan (282) (11,454)  
Proceeds from issuance of senior secured term loan   300,000  
Repayment of Convertible Notes   (150,000)  
Payments on deferred and contingent consideration obligation   (40,400)  
Proceeds from employee stock purchase plan 5,954 6,450 5,792
Payment of finance lease principal (1,379) (1,276) (2,224)
Proceeds from stock purchase agreement   50,000  
Net cash provided by financing activities 646,400 167,952 20,877
Effect of exchange rate changes on cash 3,114 (2,772) (7,821)
Net increase (decrease) in cash and cash equivalents 314,359 98,707 (19,094)
Cash and cash equivalents, and restricted cash beginning of period 295,925 197,218 216,312
Cash and cash equivalents, and restricted cash end of period 610,284 295,925 197,218
Supplemental disclosure of cash information      
Cash paid for interest 36,131 18,463 9,588
Cash paid for income taxes 14,155 4,922 7,708
Supplemental disclosure of non-cash investing and financing activity      
Unrealized gain (loss) on marketable securities, net of tax 820 108 (2,502)
Right-of-use assets obtained in exchange for operating lease obligations   35,817 645
Acquisition of product rights and licenses 54,618 33,239 $ 22,294
Milestone payable $ 2,500    
Debt issuance costs related to senior secured term loan   159  
Capital expenditures unpaid at the end of period   $ 308