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Consolidated Statements of Cash Flows - USD ($) $ in Thousands | 3 Months Ended
--- | ---
Mar. 31, 2024 | Mar. 31, 2023
Cash flows from operating activities |  |
Net Income (Loss) | $ (91,576) | $ (138,959)
Adjustments to reconcile net loss to net cash used in operating activities: |  |
Depreciation and amortization | 55,395 | 42,825
Non-cash operating lease expense | 1,792 | 2,942
Non-cash royalty revenue related to sale of future royalties | (25,228) | (13,237)
Non-cash interest expense on liability related to sale of future royalties | 50,064 | 18,902
Change in valuation of contingent consideration | (100) | 2,400
Unrealized (gain) loss on ClearPoint Equity Investments | (9) | 39
Unrealized gain on ClearPoint convertible debt security | (166) | (59)
Unrealized gain on marketable securities - equity investments | (710) | (2,166)
Disposal of asset | 544 |
Deferred income taxes | (1) | (4)
Amortization of discounts on investments, net | (3,697) | (85)
Amortization of debt issuance costs | 296 | 438
Share-based compensation expense | 18,378 | 28,815
Unrealized foreign currency transaction losses (gains), net | 269 | (10,057)
Changes in operating assets and liabilities: |  |
Inventory, net | 120 | (4,612)
Prepaid expenses and other current assets | 93,904 | 57,611
Trade and royalty receivables, net | (39,500) | (43,426)
Deposits and other assets | 11,192 | 743
Accounts payable and accrued expenses | (5,389) | 33,524
Other liabilities | 5,984 | (3,988)
Deferred revenue | (801) | (1,137)
Net cash provided by (used in) operating activities | 70,761 | (29,491)
Cash flows from investing activities |  |
Purchases of fixed assets | (9,588) | (10,270)
Purchases of marketable securities - available for sale | (104,373) |
Purchases of marketable securities - equity investments | (9,065) |
Sale and redemption of marketable securities- available for sale | 61,650 | 12,500
Sale and redemption of marketable securities - equity investments | 1,207 | 2,196
Acquisition of product rights and licenses | (54,763) | (33,397)
Net cash used in investing activities | (114,932) | (28,971)
Cash flows from financing activities |  |
Proceeds from exercise of options | 2,030 | 5,655
Debt issuance costs related to secured term loan |  | (182)
Payment of finance lease principal | (1,490) | (1,379)
Net cash provided by financing activities | 540 | 4,094
Effect of exchange rate changes on cash | (2,030) | (7,963)
Net decrease in cash and cash equivalents | (45,661) | (62,331)
Cash and cash equivalents, and restricted cash beginning of period | 610,284 | 295,925
Cash and cash equivalents, and restricted cash end of period | 564,623 | 233,594
Supplemental disclosure of cash information |  |
Cash paid for interest | 3,666 | 12,956
Cash paid for income taxes | 2,042 | 2,215
Supplemental disclosure of non-cash investing and financing activity |  |
Unrealized (loss) gain on marketable securities, net of tax | (444) | 54
Right-of-use assets obtained in exchange for operating lease obligations | 1,723 |
Acquisition of product rights and licenses | 2,296 | 19,406
Milestone payable | $ 2,500 | 32,500
Debt issuance costs related to senior secured term loan |  | 45
Capital expenditures unpaid at the end of period |  | $ 28

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Namespace Prefix: | us-gaap_
Data Type: | xbrli:stringItemType
Balance Type: | na
Period Type: | duration