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Stock-Based Compensation - Additional Information (Detail)
3 Months Ended 6 Months Ended 9 Months Ended 12 Months Ended
Jan. 01, 2019
shares
Sep. 30, 2019
USD ($)
shares
Jun. 30, 2019
USD ($)
Mar. 31, 2019
USD ($)
Milestone
Sep. 30, 2018
USD ($)
Jun. 30, 2018
USD ($)
shares
Mar. 31, 2018
shares
Mar. 31, 2017
shares
Jun. 30, 2019
USD ($)
Sep. 30, 2019
USD ($)
$ / shares
shares
Sep. 30, 2018
USD ($)
$ / shares
shares
Dec. 31, 2018
shares
Dec. 31, 2017
Sep. 20, 2018
shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                            
Total number of options outstanding   10,712,317               10,712,317        
Common stock available for issuance under stock option plan   2,801,948               2,801,948        
Stock-based compensation expense | $   $ 43,669,000     $ 25,478,000         $ 122,552,000 $ 70,323,000      
Weighted average grant date fair value per share | $ / shares                   $ 99.49 $ 113.12      
2011 Stock Option Plan [Member]                            
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                            
Options granted                   0        
2014 Stock Option Plan [Member]                            
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                            
Common stock shares annual increase added to plan 1,875,530                          
2014 Stock Option Plan [Member] | Maximum [Member]                            
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                            
Percentage of increase on outstanding shares of Common stock                       4.00%    
2016 Stock Option Plan [Member]                            
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                            
Total number of shares reserved for issuance                           1,200,000
Restricted Stock Units [Member]                            
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                            
Restricted stock units granted               32,500   386,714        
Share based compensation granted under plan vested period               2 years            
Fair value of restricted stock units vested | $                   $ 2,000,000.0 $ 2,600,000      
Stock-based compensation expense | $   10,934,000     164,000         10,992,000 $ 487,000      
Restricted Stock Units [Member] | Restricted Stock Units Vest One Year Anniversary [Member]                            
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                            
Restricted stock units cliff vesting percentage               50.00%            
Restricted stock units vesting period month and year               2018-02            
Restricted Stock Units [Member] | Restricted Stock Units Vest Two Year Anniversary [Member]                            
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                            
Restricted stock units cliff vesting percentage               50.00%            
Restricted stock units vesting period month and year               2019-02            
Performance Restricted Stock Units [Member]                            
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                            
Restricted stock units granted             33,600              
Fair value of restricted stock units vested | $   $ 11,100,000     0         $ 11,100,000        
Percentage Of Milestone Achieved                   18.00%        
Performance Restricted Stock Units [Member] | Commercial Milestones [Member]                            
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                            
Restricted stock units granted   16,258       37,800       386,714        
Performance Shares [Member]                            
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                            
Options granted   0               0 524,003      
Total unrecognized stock-based compensation expense | $   $ 35,100,000               $ 35,100,000        
Number of shares outstanding and unvested stock options   490,675               490,675        
Performance-Based Stock Options [Member]                            
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                            
Milestones not achieved | Milestone       1                    
Stock-based compensation expense | $   $ 0   $ 14,200,000           $ 0        
Percentage of performance based grants that were achieved                       20.00% 33.00%  
Performance-Based Stock Options [Member] | Consultant [Member]                            
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                            
Stock-based compensation expense | $           $ 6,900,000                
Commercial Milestones [Member]                            
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                            
Stock-based compensation expense | $     $ 2,100,000           $ 16,300,000          
Stock Options [Member]                            
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                            
Options granted                   1,428,948        
Total number of options outstanding   7,575,997               7,575,997   7,530,767    
Stock-based compensation expense | $   $ 32,119,000     $ 25,015,000         $ 109,963,000 $ 69,023,000      
Total unrecognized stock-based compensation expense | $   $ 285,000,000.0               $ 285,000,000.0        
Weighted average period of unrecognized compensation costs                   2 years 6 months 14 days        
Intrinsic value of options exercised | $                   $ 115,200,000 $ 93,000,000.0