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Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
 3 Months Ended 9 Months Ended 12 Months Ended
Sep. 30, 2024
Sep. 30, 2023
Sep. 30, 2024
Sep. 30, 2023
Dec. 31, 2023
Cash flows from operating activities          
Net Income (Loss) $ (106,654) $ (132,970) $ (297,409) $ (470,812)  
Adjustments to reconcile net loss to net cash used in operating activities:          
Depreciation and amortization     68,899 155,885  
Non-cash operating lease expense     6,272 8,156  
Non-cash royalty revenue related to sale of future royalties     (128,877) (50,599)  
Non-cash interest expense on liability related to sale of future royalties     155,039 56,031  
Intangible asset impairment       217,800  
Change in valuation of contingent consideration     5,700 (125,000)  
Tangible asset impairment     1,486    
Loss on sale of fixed assets     4,298    
Gain on lease terminations     (2,179)    
Unrealized (gain) loss on ClearPoint Equity Investments     (3,954) 3,107  
Unrealized loss on ClearPoint convertible debt security     1,931 4,594  
Unrealized gain on marketable securities - equity investments     (1,923) (5,484)  
Realized loss for the sale of ClearPoint Equity Investment       782  
Realized loss on ClearPoint convertible debt security     622    
Non-cash stock consideration, milestone payment       29,570  
Disposal of asset     76 135  
Deferred income taxes     (2) (50,909) $ (46,900)
Amortization of discounts on investments, net     (9,947) (89)  
Amortization of debt issuance costs     891 1,574  
Share-based compensation expense     57,376 85,128  
Unrealized foreign currency transaction losses, net     (147) 3,394  
Changes in operating assets and liabilities:          
Inventory, net     (4,922) (14,121)  
Prepaid expenses and other current assets     107,957 59,467  
Trade and royalty receivables, net     (39,029) (9,887)  
Deposits and other assets     7,909 4,597  
Accounts payable and accrued expenses     (417) 40,434  
Other liabilities     (4,733) (1,756)  
Deferred revenue     (801) (127)  
Payments on contingent consideration     (1,800)    
Net cash used in operating activities     (77,684) (58,130)  
Cash flows from investing activities          
Purchases of fixed assets     (2,735) (22,872)  
Proceeds from sale of fixed assets     28,056    
Purchases of marketable securities - available for sale     (476,680)    
Purchases of marketable securities - equity investments     (49,614) (26,378)  
Sale and redemption of marketable securities- available for sale     290,836 21,544  
Sale and redemption of marketable securities - equity investments     41,624 12,078  
Sale and redemption of ClearPoint Equity Investments       2,594  
Proceeds from principal payment of Clearpoint convertible debt security     10,000    
Acquisition of product rights and licenses     (65,017) (69,285)  
Net cash used in investing activities     (223,530) (82,319)  
Cash flows from financing activities          
Proceeds from exercise of options     5,320 23,771  
Proceeds from employee stock purchase plan     1,973 3,805  
Proceeds from sales of future royalties     241,792    
Debt issuance costs related to secured term loan       (282)  
Payments on contingent consideration     (18,200)    
Payment of finance lease principal     (1,490) (1,379)  
Net cash provided by financing activities     229,395 25,915  
Effect of exchange rate changes on cash     1,325 19  
Net decrease in cash and cash equivalents     (70,494) (114,515)  
Cash and cash equivalents, and restricted cash beginning of period     610,284 295,925 295,925
Cash and cash equivalents, and restricted cash end of period 539,790 181,410 539,790 181,410 $ 610,284
Supplemental disclosure of cash information          
Cash paid for interest     5,823 34,020  
Cash paid for income taxes     12,781 13,631  
Supplemental disclosure of non-cash investing and financing activity          
Unrealized gain on marketable securities, net of tax 2,760 19 2,204 470  
Right-of-use assets obtained in exchange for operating lease obligations     5,786    
Acquisition of product rights and licenses     2,346 44,963  
Fixed asset additions through tenant improvement allowance     18,675    
Milestone payable $ 50,000 $ 2,500 $ 50,000 $ 2,500