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Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)
$ in Thousands
 9 Months Ended
Sep. 30, 2018
Sep. 30, 2017
Operating activities:    
Net loss $ (129,281) $ (134,994)
Adjustments to reconcile net loss to net cash used for operating activities:    
Stock-based compensation expense 23,572 23,647
Depreciation and amortization 1,093 1,146
Amortization of debt discount 654 570
(Gain) Loss on disposal of property and equipment 3 (7)
Accretion of discount on short-term investments (1,920) (259)
Change in operating assets and liabilities:    
Accounts receivable (11,759) (26,891)
Prepaid expenses and other current assets (6,505) (849)
Inventory (21,502) 171
Accounts payable (9,125) (1,477)
Accrued clinical liabilities (12,639) 2,310
Accrued payroll and employee liabilities (403) (564)
Deferred revenue 4,461
Other accrued liabilities 9,494 9,585
Net cash used for operating activities (158,318) (123,151)
Investing activities:    
Purchases of short-term investments (400,382) (93,776)
Maturities and sales of short-term investments 119,200 123,284
Purchases of property and equipment (5,696) (1,419)
Proceeds from the sale of property and equipment 13
Net cash (used for) provided by investing activities (286,878) 28,102
Financing activities:    
Net proceeds from sale of common stock 363,128 163,747
Repayment of promissory note payable to related party (25,000) (25,000)
Proceeds from stock option exercises 15,771 7,836
Proceeds from purchases under the Employee Stock Purchase Plan 648 576
Net cash provided by financing activities 354,547 147,159
Net (decrease) increase in cash and cash equivalents (90,649) 52,110
Cash and cash equivalents at beginning of year 144,583 13,414
Cash and cash equivalents at end of period 53,934 65,524
Supplemental disclosure of cash flow information:    
Interest paid 1,183 2,289
Cumulative effect of adoption of new accounting standard $ 1,574