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Revenue Recognition - Adoption of Topic 606 (Details) - USD ($) $ / shares in Units, $ in Thousands |  | 3 Months Ended | 12 Months Ended
--- | --- | --- | ---
Jan. 01, 2018 | Dec. 31, 2019 | Sep. 30, 2019 | Jun. 30, 2019 | Mar. 31, 2019 | Dec. 31, 2018 | Sep. 30, 2018 | Jun. 30, 2018 | Mar. 31, 2018 | Dec. 31, 2019 | Dec. 31, 2018 | Dec. 31, 2017
Disaggregation Of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Inventory |  | $ 24,968 |  |  |  | $ 39,032 |  |  |  | $ 24,968 | $ 39,032 | $ 10,108
Other accrued liabilities |  | 36,535 |  |  |  | 32,715 |  |  |  | 36,535 | 32,715 | 17,175
Deferred revenue |  |  |  |  |  |  |  |  |  |  |  | 2,763
Accumulated deficit |  | (1,165,470) |  |  |  | (960,721) |  |  |  | (1,165,470) | (960,721) | (783,455)
Net product sales |  | 35,083 | $ 42,624 | $ 36,659 | $ 31,602 | 28,844 | $ 19,786 | $ 17,277 | $ 11,567 | 145,968 | 77,474 | 30,767
Cost of product sales |  | 15,874 | 17,195 | 13,588 | 14,962 | 11,572 | 7,576 | 5,231 | 3,133 | 61,619 | 27,512 | 4,588
Loss from operations |  | (59,362) | (34,853) | (51,779) | (64,700) | (51,314) | (41,780) | (38,853) | (51,990) | (210,694) | (183,937) | (194,558)
Net loss |  | $ (57,920) | $ (33,595) | $ (50,222) | $ (63,012) | $ (49,559) | $ (38,346) | $ (38,670) | $ (52,265) | $ (204,749) | $ (178,840) | $ (197,484)
Basic and diluted net loss per share |  | $ (0.65) | $ (0.42) | $ (0.63) | $ (0.80) | $ (0.63) | $ (0.49) | $ (0.54) | $ (0.81) | $ (2.50) | $ (2.44) | $ (3.65)
Adjustments to reconcile net loss to net cash used for operating activities: |  |  |  |  |  |  |  |  |  |  |  |
Inventory |  |  |  |  |  |  |  |  |  | $ 14,064 | $ (29,122) | $ (4,768)
Other accrued liabilities |  |  |  |  |  |  |  |  |  | $ 4,558 | 14,941 | 11,482
Deferred revenue |  |  |  |  |  |  |  |  |  |  |  | $ 1,664
Accounting Standards Update 2014-09 |  |  |  |  |  |  |  |  |  |  |  |
Disaggregation Of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Inventory | $ 9,910 |  |  |  |  |  |  |  |  |  |  |
Other accrued liabilities | 18,166 |  |  |  |  |  |  |  |  |  |  |
Accumulated deficit | (781,881) |  |  |  |  |  |  |  |  |  |  |
Cost of product sales | 200 |  |  |  |  |  |  |  |  |  |  |
Accounting Standards Update 2014-09 | Difference between Revenue Guidance in Effect before and after Topic 606 |  |  |  |  |  |  |  |  |  |  |  |
Disaggregation Of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Inventory | (198) |  |  |  |  | $ 2,181 |  |  |  |  | 2,181 |
Other accrued liabilities | 991 |  |  |  |  | (7,195) |  |  |  |  | (7,195) |
Deferred revenue | (2,763) |  |  |  |  | 14,010 |  |  |  |  | 14,010 |
Accumulated deficit | $ 1,574 |  |  |  |  | (4,634) |  |  |  |  | (4,634) |
Net product sales |  |  |  |  |  |  |  |  |  |  | (5,043) |
Cost of product sales |  |  |  |  |  |  |  |  |  |  | (1,983) |
Loss from operations |  |  |  |  |  |  |  |  |  |  | (3,060) |
Net loss |  |  |  |  |  |  |  |  |  |  | $ (3,060) |
Basic and diluted net loss per share |  |  |  |  |  |  |  |  |  |  | $ 0.05 |
Adjustments to reconcile net loss to net cash used for operating activities: |  |  |  |  |  |  |  |  |  |  |  |
Inventory |  |  |  |  |  |  |  |  |  |  | $ (1,983) |
Other accrued liabilities |  |  |  |  |  |  |  |  |  |  | (6,204) |
Deferred revenue |  |  |  |  |  |  |  |  |  |  | 11,247 |
Accounting Standards Update 2014-09 | Calculated under Revenue Guidance in Effect before Topic 606 |  |  |  |  |  |  |  |  |  |  |  |
Disaggregation Of Revenue [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
Inventory |  |  |  |  |  | 41,213 |  |  |  |  | 41,213 |
Other accrued liabilities |  |  |  |  |  | 25,520 |  |  |  |  | 25,520 |
Deferred revenue |  |  |  |  |  | 14,010 |  |  |  |  | 14,010 |
Accumulated deficit |  |  |  |  |  | $ (965,355) |  |  |  |  | (965,355) |
Net product sales |  |  |  |  |  |  |  |  |  |  | 72,431 |
Cost of product sales |  |  |  |  |  |  |  |  |  |  | 25,529 |
Loss from operations |  |  |  |  |  |  |  |  |  |  | (186,997) |
Net loss |  |  |  |  |  |  |  |  |  |  | $ (181,900) |
Basic and diluted net loss per share |  |  |  |  |  |  |  |  |  |  | $ (2.49) |
Adjustments to reconcile net loss to net cash used for operating activities: |  |  |  |  |  |  |  |  |  |  |  |
Inventory |  |  |  |  |  |  |  |  |  |  | $ (31,105) |
Other accrued liabilities |  |  |  |  |  |  |  |  |  |  | 8,737 |
Deferred revenue |  |  |  |  |  |  |  |  |  |  | $ 11,247 |

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