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Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Cash flows from operating activities    
Net Income (Loss) $ 817,609 $ (297,409)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:    
Depreciation and amortization 25,913 68,899
Non-cash operating lease expense 5,635 6,272
Non-cash royalty revenue related to sale of future royalties (149,160) (128,877)
Non-cash interest expense on liability related to sale of future royalties 149,305 155,039
Change in valuation of contingent consideration (800) 5,700
Tangible asset impairment 518 1,486
Loss on sale of fixed assets 130 4,298
Gain on lease terminations   (2,179)
Unrealized gain on ClearPoint Equity Investments (5,734) (3,954)
Unrealized loss on ClearPoint convertible debt security   1,931
Unrealized gain on marketable securities - equity investments (3,160) (1,923)
Realized loss on ClearPoint convertible debt security   622
Disposal of asset 163 76
Deferred income taxes (4) (2)
Amortization of discounts on investments, net (12,972) (9,947)
Amortization of debt issuance costs 906 891
Share-based compensation expense 56,029 57,376
Unrealized foreign currency transaction losses (gains), net 4,768 (147)
Changes in operating assets and liabilities:    
Inventory, net (27,117) (4,922)
Prepaid expenses and other current assets (13,876) 107,957
Trade and royalty receivables, net (32,365) (39,029)
Deposits and other assets 1,501 7,909
Accounts payable and accrued expenses (36,341) (417)
Other liabilities (26,497) (4,733)
Deferred revenue (4,298) (801)
Payments on contingent consideration (4,684) (1,800)
Net cash provided by (used in) operating activities 745,469 (77,684)
Cash flows from investing activities    
Purchases of fixed assets (6,486) (2,735)
Proceeds from sale of fixed assets 70 28,056
Purchases of marketable securities- available for sale (1,051,267) (476,680)
Purchases of marketable securities- equity investments (46,537) (49,614)
Sale and redemption of marketable securities- available for sale 424,351 290,836
Sale and redemption of marketable securities- equity investments 40,112 41,624
Proceeds from settlement of Clearpoint convertible debt security   10,000
Acquisition of product rights and licenses (256,235) (65,017)
Net cash used in investing activities (895,992) (223,530)
Cash flows from financing activities    
Proceeds from exercise of options 33,715 5,320
Proceeds from employee stock purchase plan 2,827 1,973
Proceeds from sale of future royalties   241,792
Payments on contingent consideration obligation (6,341) (18,200)
Payment of finance lease principal (1,611) (1,490)
Net cash provided by financing activities 28,590 229,395
Effect of exchange rate changes on cash 12,917 1,325
Net decrease in cash and cash equivalents (109,016) (70,494)
Cash and cash equivalents, and restricted cash beginning of period 795,316 610,284
Cash and cash equivalents, and restricted cash end of period 686,300 539,790
Supplemental disclosure of cash information    
Cash paid for interest 5,702 5,823
Cash paid for income taxes 40,124 12,781
Supplemental disclosure of non-cash investing and financing activity    
Unrealized gain on marketable securities, net of tax 402 2,204
Right-of-use assets obtained in exchange for operating lease obligations 27,675 5,786
Acquisition of product rights and licenses 2,221 2,346
Fixed asset additions through tenant improvement allowance 766 18,675
Milestone payable $ 32,500 $ 50,000