Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021
Cash flows from operating activities:
Net loss	$ (594,244)	$ (296,799)
Adjustments to reconcile net loss to cash flows from operating activities:
Gain on contingent consideration, net	(6,700)	(7,200)
Loss on debt extinguishment	125,441	0
Depreciation and amortization	31,311	27,872
Reduction in the carrying amounts of the right of use assets	9,182	10,112
Non-cash interest expense	6,027	5,617
Stock-based compensation	182,508	84,161
Loss on disposal of assets	5,456	448
Gain from sale of Priority Review Voucher	0	(102,000)
Impairment of equity investment	0	4,488
Other	(3,858)	3,516
Changes in operating assets and liabilities, net:
Net increase in accounts receivable	(48,519)	(48,447)
Net increase in inventory	(41,900)	(56,508)
Net decrease in other assets	34,398	74,155
Net decrease in deferred revenue	(66,750)	(66,750)
Net decrease in accounts payable, accrued expenses, lease liabilities and other liabilities	134,694	(46,511)
Net cash used in operating activities	(232,954)	(413,846)
Cash flows from investing activities:
Purchase of property and equipment	(22,860)	(36,284)
Purchase of available-for-sale securities	(1,509,316)	(29,988)
Maturity and sale of available-for-sale securities	476,722	466,000
Proceeds from sale of Priority Review Voucher, net of commission	0	102,000
Other	(1,225)	(3,738)
Net cash (used in) provided by investing activities	(1,056,679)	497,990
Cash flows from financing activities:
Proceeds from 2027 Notes offering, net	1,127,400	0
Debt issuance costs for 2027 Notes	(162)	0
Repayment of principal amount due under 2019 Term Loan	(550,000)	0
Payment on debt extinguishment of 2019 Term Loan	(25,364)	0
Repurchase of 2024 Notes	(247,868)	0
Purchase Of Capped Call Share Options For 2027 Notes	(127,305)	0
Partial settlement of capped call share options for 2024 Notes	26,317	0
Proceeds from exercise of stock options and purchase of stock under the Employee Stock Purchase Program	18,740	18,654
Taxes paid related to net share settlement of equity awards	0	(6,333)
Net cash provided by financing activities	221,758	12,321
Decrease in cash, cash equivalents and restricted cash	(1,067,875)	96,465
Cash, cash equivalents and restricted cash:
Beginning of period	2,125,523	1,511,713
End of period	1,057,648	1,608,178
Reconciliation of cash, cash equivalents and restricted cash:
Total cash, cash equivalents and restricted cash	1,057,648	1,608,178
Cash and cash equivalents	1,038,624	1,599,113
Restricted cash in other assets	19,024	9,065
Supplemental disclosure of cash flow information:
Cash paid during the period for interest	41,273	39,727
Supplemental schedule of non-cash investing activities and financing activities:
Accrued debt issuance costs for 2027 Notes	553	0
Intangible assets and property and equipment included in accounts payable and accrued expenses	5,511	4,644
Lease liabilities arising from obtaining right of use assets	12,281	13,148
Lease liabilities terminated	3,807	19,967
Shares withheld for tax included in accrued expenses	$ 0	$ 1,432