Consolidated Statements of Cash Flows - USD ($) $ in Thousands		12 Months Ended
		Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Cash flows from operating activities:
Net loss		$ (703,488)	$ (418,780)	$ (554,128)
Adjustments to reconcile net loss to cash flows in operating activities:
(Gain) loss on contingent consideration, net	[1]	(6,700)	(7,200)	45,000
Loss from debt extinguishment		125,441	0	0
Gain from sale of Priority Review Voucher, net of commission		0	(102,000)	(108,069)
Depreciation and amortization		41,864	38,017	26,911
Reduction in the carry amounts of the right of use assets		12,735	11,325	12,828
Non-cash interest expense		7,552	7,581	25,454
Stock-based compensation		233,018	113,943	108,070
Loss on disposal of assets		10,770	456	85
Impairment of equity investment		2,575	4,488	0
Other		(9,643)	7,164	(2,741)
Changes in operating assets and liabilities, net:
Net increase in accounts receivable		(61,638)	(51,650)	(10,461)
Net increase in inventory		(50,780)	(83,772)	(60,582)
Net decrease (increase) in other assets		14,620	103,203	(166,328)
Net (decrease) increase in deferred revenue		(89,244)	(89,244)	749,429
Net increase in accounts payable, accrued expenses, lease liabilities and other liabilities		147,572	23,297	41,998
Net cash (used in) provided by operating activities		(325,346)	(443,172)	107,466
Cash flows from investing activities:
Purchase of property and equipment		(30,824)	(38,490)	(82,202)
Purchase of available-for-sale securities		(1,936,856)	(29,988)	(1,333,568)
Maturity and sales of available-for-sale securities		923,224	466,000	1,189,480
Proceeds from sale of Priority Review Voucher, net of commission		0	102,000	108,069
Other		(2,427)	(4,109)	(3,500)
Net cash provided by (used in) investing activities		(1,046,883)	495,413	(121,721)
Cash flows from financing activities:
Proceeds from 2027 Notes offering, net of commissions		1,127,400	0	0
Debt issuance costs		(716)	0	0
Purchase Of Capped Call Share Options For 2027 Notes		(127,305)	0	0
Repurchase of 2024 Notes		(247,868)	0	0
Partial settlement of capped call share options for 2024 Notes		26,317	0	0
Repayment of principal amount due under 2019 Term Loan		(550,000)	0	0
Payment on debt extinguishment of 2019 Term Loan		(25,364)	0	0
Proceeds from 2019 Term Loan		0	0	291,150
Debt issuance costs for 2019 Term Loan		0	0	(39)
Proceeds from exercise of stock options and purchase of stock under the Employee Stock Purchase Program		30,043	20,802	83,957
Taxes paid related to net share settlement of equity awards		0	(7,765)	(4,798)
Proceeds from sales of common stock, net of offering costs		0	548,532	0
Proceeds from issuance of common stock to Roche, net of offering costs		0	0	312,053
Net cash provided by financing activities		232,507	561,569	682,323
(Decrease) increase in cash and cash equivalents		(1,139,722)	613,810	668,068
Cash, cash equivalents and restricted cash:
Beginning of year		2,125,523	1,511,713	843,645
End of year		985,801	2,125,523	1,511,713
Reconciliation of cash, cash equivalents and restricted cash:
Cash and cash equivalents		966,777	2,115,869	1,502,648
Restricted cash in other assets		19,024	9,654	9,065
Total cash, cash equivalents and restricted cash		985,801	2,125,523	1,511,713
Supplemental disclosure of cash flow information:
Cash paid during the period for interest		44,418	55,949	34,418
Cash paid during the period for income taxes		1,695	583	2,510
Supplemental schedule of non-cash activities:
Lease liabilities arising from obtaining right of use assets		40,006	13,225	59,327
Lease liabilities terminated		3,807	40,133	0
Intangible assets and property and equipment included in accounts payable and accrued expenses		6,765	4,162	5,151
Shares withheld for tax included in accrued expenses		0	0	6,333
Accrued debt issuance costs		$ 0	$ 0	$ 11,000

[1] * The gain (loss) on contingent consideration, net is related to the fair value adjustment of the regulatory-related contingent payments that are accounted for as derivatives. Please see Note 5. Fair Value Measurements for further details.