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Income Taxes (Tables)

12 Months Ended

Dec. 31, 2023

Income Tax Disclosure [Abstract]

Summary of Domestic and Foreign Pre-tax Loss

Domestic and foreign pre-tax income (loss) is as follows (in thousands):

		Years Ended December 31,
		2023				2022				2021
Domestic		$	(100,215	)		$	(233,216	)		$	(138,913	)
Foreign			49,179				19,772				(28,606	)
		$	(51,036	)		$	(213,444	)		$	(167,519	)

Schedule of income tax provision consists

The income tax provision consists of the following (in thousands):

		Years Ended December 31,
		2023				2022				2021
Current provision:
Federal		$	5,440			$	—			$	—
State			4,805				2,531				351
Foreign			5				—				—
Total deferred tax assets			10,250				2,531				351
Total income tax provision		$	10,250			$	2,531			$	351

Components of Deferred Tax Assets

The components of the deferred tax assets are as follows (in thousands):

		December 31,
		2023				2022
Deferred tax assets
NOL carryforwards		$	149,049			$	225,993
R&D credit carryforwards			70,906				83,074
Capitalized R&D			90,164				38,507
Stock-based compensation			51,028				51,661
Charitable contributions			40,956				42,677
Lease liabilities			13,671				14,730
Intangibles			43,220				24,030
Property and equipment			51				—
Accrued rebates			19,401				5,748
Other			16,036				8,022
Total deferred tax assets			494,482				494,442
Valuation allowance			(482,089	)			(481,210	)
Deferred tax liabilities
Property and equipment			—				(29	)
Right-of-use assets			(12,393	)			(13,203	)
Total deferred tax liabilities			(12,393	)			(13,232	)
Total net deferred tax assets		$	—			$	—

Reconciliation of Income Taxes to Amount Computed by Applying Statutory Federal Income Tax Rate to Pretax Loss

A reconciliation of income taxes to the amount computed by applying the statutory federal income tax rate to the pretax loss is summarized as follows (in thousands):

		Years Ended December 31,
		2023				2022				2021
Amounts computed at statutory federal rate		$	(10,718	)		$	(44,823	)		$	(35,179	)
Stock-based compensation and other permanent differences			8,458				7,596				6,083
Branded pharmaceutical drug fee			1,848				1,454				613
Write-off of IP R&D			—				2,449				1,277
R&D credits			(5,827	)			(9,974	)			(11,727	)
Change in valuation allowance			1,100				11,227				36,099
State taxes			(977	)			(2,232	)			(2,617	)
Contingencies			(2,071	)			6,993				3,879
Foreign rate differential			(5,076	)			(1,971	)			2,857
Deferred adjustments for limits on executive compensation			2,112				3,918				1,808
Deferred rate adjustment			(192	)			922				(2,424	)
Switzerland tax reform			(246	)			—				(923	)
Expiration of attributes			17,225				16,142				726
GILTI			7,665				10,804				—
Other			(3,051	)			26				(121	)
Income tax expense		$	10,250			$	2,531			$	351

Unrecognized Tax Benefits

The following table provides a reconciliation of changes in unrecognized tax benefits (in thousands):

		Years Ended December 31,
		2023				2022				2021
Balance at beginning of period		$	19,064			$	13,923			$	9,843
Additions related to current period tax positions			5,304				5,140				3,973
Additions related to prior period tax positions			12,956				38				140
Reductions related to prior period tax positions			(212	)			(37	)			(33	)
Balance at end of period		$	37,112			$	19,064			$	13,923

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