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Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2018
Dec. 31, 2017
Dec. 31, 2016
Operating activities:      
Net loss $ (178,840) $ (197,484) $ (173,143)
Adjustments to reconcile net loss to net cash used for operating activities:      
Stock-based compensation expense 33,367 30,538 25,956
Depreciation and amortization 1,513 1,531 1,099
Amortization of debt discount 890 773 689
(Accretion of discount) amortization of premium on short-term investments (3,412) (278) 274
Impairment of property and equipment 72
Loss on disposal of property and equipment 29 39 9
Change in operating assets and liabilities:      
Accounts receivable (22,778) (39,914) (1,960)
Prepaid expenses and other assets (7,482) 3 (338)
Inventory (29,122) (4,768) (5,340)
Accounts payable (1,906) 11,955 3,514
Accrued clinical and manufacturing liabilities (3,614) 13,713 7,976
Accrued payroll and employee liabilities 4,537 446 3,586
Deferred revenue 1,664 1,099
Other accrued liabilities 14,941 11,482 2,482
Net cash used for operating activities (191,805) (170,300) (134,097)
Investing activities:      
Purchases of short-term investments (497,104) (121,570) (43,318)
Maturities of short-term investments 227,700 131,783 61,329
Purchases of property and equipment (9,171) (2,553) (3,135)
Proceeds from the sale of property and equipment 25 78
Net cash (used for) provided by investing activities (278,550) 7,738 14,876
Financing activities:      
Net proceeds from sale of common stock and/or pre-funded warrants 363,128 306,279
Proceeds from purchases under the Employee Stock Purchase Plan 1,179 989 771
Proceeds from stock option exercises 18,301 11,463 6,684
Proceeds from issuance of promissory note payable to related party 50,000
Repayment of promissory note payable to related party (25,000) (25,000)
Net cash provided by financing activities 357,608 293,731 57,455
Net (decrease) increase in cash and cash equivalents (112,747) 131,169 (61,766)
Cash and cash equivalents at beginning of year 144,583 13,414 75,180
Cash and cash equivalents at end of year 31,836 144,583 13,414
Supplemental disclosure of cash flow information:      
Interest paid 1,183 2,789 1,622
Cumulative effect of adoption of new accounting standard $ 1,574