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Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2017
Dec. 31, 2016
Dec. 31, 2015
Operating activities:      
Net loss $ (197,484) $ (173,143) $ (97,591)
Adjustments to reconcile net loss to net cash used for operating activities:      
Stock-based compensation expense 30,538 25,956 14,360
Depreciation and amortization 1,531 1,099 734
Amortization of debt discount 773 689 624
Loss (gain) on disposal of property and equipment 39 9 (118)
(Accretion of discount) amortization of premium on short-term investments (278) 274 89
Change in operating assets and liabilities:      
Accounts receivable (39,914) (1,960)
Prepaid expenses and other current assets 3 (338) (2,443)
Inventory (4,768) (5,340)
Accounts payable 11,955 3,514 751
Accrued clinical liabilities 13,713 7,976 1,420
Accrued payroll and employee liabilities 446 3,586 2,097
Deferred revenue 1,664 1,099
Other accrued liabilities 11,482 2,482 1,551
Net cash used for operating activities (170,300) (134,097) (78,526)
Investing activities:      
Purchases of short-term investments (121,570) (43,318) (56,115)
Maturities of short-term investments 131,783 61,329
Purchases of property and equipment (2,553) (3,135) (1,086)
Proceeds from the sale of property and equipment 78 241
Net cash provided by (used for) investing activities 7,738 14,876 (56,960)
Financing activities:      
Net proceeds from sale of common stock and/or pre-funded warrants 306,279 128,199
Proceeds from purchases under the Employee Stock Purchase Plan 989 771 257
Proceeds from stock option exercises 11,463 6,684 9,535
Proceeds from issuance of promissory note payable to related party 50,000
Repayment of promissory note payable to related party (25,000)
Net cash provided by financing activities 293,731 57,455 137,991
Net increase (decrease) in cash and cash equivalents 131,169 (61,766) 2,505
Cash and cash equivalents at beginning of year 13,414 75,180 72,675
Cash and cash equivalents at end of year 144,583 13,414 75,180
Supplemental disclosure of cash flow information:      
Interest paid $ 2,789 $ 1,622