Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Operating activities
Net loss	$ (434,654)	$ (294,090)	$ (254,337)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation	9,130	9,147	5,188
Amortization of intangible assets	5,052	5,003	4,993
Stock-based compensation expense	46,021	36,158	26,971
Loss on extinguishment of debt	17,689	0	0
Amortization of debt issuance costs and accretion of debt discount	31,039	20,378	19,382
Finance lease amortization expense	1,078	1,078	360
Noncash operating lease expense	12,589	5,932	9,763
Change in fair value of deferred and contingent consideration liabilities	7,334	0	0
Changes in operating assets and liabilities:
Accounts receivable	(8,118)	2,670	(13,717)
Inventory	(17,456)	(21,180)	(21,281)
Prepaid expenses and other current assets	(5,549)	(3,114)	(8,718)
Other assets	(24,435)	(6,261)	(16,008)
Accounts payable	(7,575)	29,825	(4,966)
Accrued liabilities, accrued compensation and other	4,553	(4,894)	1,721
Net cash used in operating activities	(363,302)	(219,348)	(250,649)
Investing activities
Purchase of fixed assets	(7,289)	(6,240)	(42,268)
Purchase of marketable securities	(50,292)	0	0
Cash paid for Business Acquisition, net	(6,704)	0	0
PARI milestone upon regulatory approvals	0	(582)	0
Net cash used in investing activities	(64,285)	(6,822)	(42,268)
Financing activities
Proceeds from exercise of stock options, ESPP, and RSU vesting	22,037	26,073	19,701
Proceeds from issuance of common stock, net	269,886	245,866	261,074
Payment on extinguishment of 1.75% convertible senior notes due 2025	(12,578)	0	0
Payment of principal of 1.75% convertible senior notes due 2025	(225,000)	0	0
Proceeds from issuance of 0.75% convertible senior notes due 2028	575,000	0	0
Payment of debt issuance costs	(15,718)	0	0
Other financing activities	(1,081)	(936)	4,503
Net cash provided by financing activities	612,546	271,003	285,278
Effect of exchange rates on cash and cash equivalents	(933)	494	(4)
Net increase (decrease) in cash and cash equivalents	184,026	45,327	(7,643)
Cash and cash equivalents at beginning of period	532,756	487,429	495,072
Cash and cash equivalents at end of period	716,782	532,756	487,429
Supplemental disclosures of cash flow information:
Cash paid for interest	10,890	9,186	7,883
Cash paid for income taxes	$ 1,558	$ 814	$ 339