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Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)
$ in Thousands
 3 Months Ended
Mar. 31, 2018
Mar. 31, 2017
Operating activities:    
Net loss $ (52,265) $ (50,329)
Adjustments to reconcile net loss to net cash used for operating activities:    
Stock-based compensation expense 7,701 8,021
Depreciation and amortization 381 329
Amortization of debt discount 210 185
Loss on disposal of property and equipment 5
Accretion of discount on short-term investments (211) (13)
Change in operating assets and liabilities:    
Accounts receivable 4,161 (8,367)
Prepaid expenses and other current assets (1,845) 274
Inventory (9,508) 699
Accounts payable (7,311) (2,337)
Accrued clinical liabilities (1,986) (1,983)
Accrued payroll and employee liabilities (3,612) (2,292)
Deferred revenue 4,136
Other accrued liabilities 2,572 1,091
Net cash used for operating activities (61,713) (50,581)
Investing activities:    
Purchases of short-term investments (39,388) (69,374)
Maturities and sales of short-term investments 25,395
Purchases of property and equipment (904) (938)
Net cash used for investing activities (40,292) (44,917)
Financing activities:    
Net proceeds from sale of common stock (205) 163,747
Proceeds from stock option exercises 4,202 1,850
Net cash provided by financing activities 3,997 165,597
Net (decrease) increase in cash and cash equivalents (98,008) 70,099
Cash and cash equivalents at beginning of year 144,583 13,414
Cash and cash equivalents at end of period 46,575 83,513
Supplemental disclosure of cash flow information:    
Interest paid 500 1,000
Cumulative effect of adoption of new accounting standard $ 1,573