| Pay vs Performance Disclosure - USD ($) | 12 Months Ended |
| Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 |
| Pay vs Performance Disclosure [Table] | | | |
| Pay vs Performance [Table Text Block] | Value of Initial Fixed $100 Investment Based On: Year Summary Compensation Table Total for PEO (1) Compensation Actually Paid to PEO (2) Average Summary Compensation Table Total for Non-PEO NEOs (3) Average Compensation Actually Paid to Non-PEO NEOs (4) Total Stockholder Return (5) Peer Group Total Stockholder Return (Nasdaq Biotechnology Index) (6) Net Income (in thousands) (7) Total Revenue (in thousands) (8) 2022 $ 8,246,281 $ (10,478,887) $ 4,548,786 $ (4,682,784) $ 119.23 $ 111.27 $ (547,799) $ 820,222 2021 $ 23,343,147 $ 17,842,930 $ 8,415,636 $ 7,334,133 $ 277.20 $ 124.89 $ (471,716) $ 625,486 2020 $ 8,083,213 $ 60,865,789 $ 2,795,161 $ 24,672,935 $ 295.40 $ 125.69 $ (229,743) $ 391,005 (1) Our PEO for each year reported is Steve Chapman , our Chief Executive Officer. The dollar amounts reported in this column are the amounts of total compensation reported for Mr. Chapman in the “Total” column of the Summary Compensation Table in the applicable fiscal year. (2) In accordance with SEC rules, the following adjustments were made to determine the compensation actually paid to our PEO during fiscal years 2022, 2021 and 2020, which consisted solely of adjustments to the PEO’s equity awards: Description of Adjustment 2022 2021 2020 Summary Compensation Table – Total Compensation $ 8,246,281 $ 23,343,147 $ 8,083,213 - grant date fair value of option awards and stock awards granted in the covered fiscal year $ (7,093,675) $ (22,417,562) $ (7,291,047) + fair value at fiscal year end of outstanding and unvested option awards and stock awards granted in the covered fiscal year $ 4,352,420 $ 14,282,938 $ 25,400,473 + change in fair value of outstanding and unvested option awards and stock awards granted in prior fiscal years $ (11,074,522) $ (745,043) $ 21,714,867 + fair value on vesting date of option awards and stock awards granted in the covered fiscal year that vested during the covered fiscal year $ 550,650 $ 0 $ 6,497,053 + change in fair value as of the vesting date of option awards and stock awards granted in prior fiscal years that vested in the covered fiscal year $ (5,460,040) $ 3,379,450 $ 6,461,230 - fair value of as of prior fiscal year end of option awards and stock awards granted in prior fiscal years that failed to meet applicable vesting conditions during the covered fiscal year $ 0 $ 0 $ 0 + dollar value of dividends or earnings paid on option awards or stock awards in the covered fiscal year prior to vesting that are not otherwise included in total compensation $ 0 $ 0 $ 0 Total Equity Adjustments (subtotal)* $ (18,725,167) $ (5,500,217) $ 52,782,576 Compensation Actually Paid $ (10,478,887) $ 17,842,930 $ 60,865,789 * Calculations reflect equity granted over a span of seven years of service prior to, as well as during, the reported fiscal years. (3) The non-PEO NEOs for each year reported are as follows: For 2022: Michael Brophy, Robert Schueren, Daniel Rabinowitz, and Matthew Rabinowitz For 2021: Michael Brophy, Robert Schueren, Daniel Rabinowitz, and Matthew Rabinowitz For 2020: Michael Brophy, Robert Schueren, Matthew Rabinowitz, and Jonathan Sheena The dollar amounts reported in this column represent the average of the amounts reported for the non-PEO NEOs in the “Total” column of the Summary Compensation Table in the applicable fiscal year. (4) In accordance with SEC rules, the following adjustments were made to determine the compensation actually paid on average to our non-PEO NEOs during fiscal years 2022, 2021 and 2020, which consisted solely of adjustments to the non-PEO NEOs’ equity awards: Description of Adjustment 2022 2021 2020 Summary Compensation Table – Total Compensation $ 4,548,786 $ 8,415,636 $ 2,795,161 - grant date fair value of option awards and stock awards granted in the covered fiscal year $ (3,982,802) $ (7,808,661) $ (2,262,392) + fair value at fiscal year end of outstanding and unvested option awards and stock awards granted in the covered fiscal year $ 2,256,160 $ 6,278,945 $ 10,304,088 + change in fair value of outstanding and unvested option awards and stock awards granted in prior fiscal years $ (4,777,779) $ (488,996) $ 8,640,852 + fair value on vesting date of option awards and stock awards granted in the covered fiscal year that vested during the covered fiscal year $ 256,134 $ 0 $ 562,800 + change in fair value as of the vesting date of option awards and stock awards granted in prior fiscal years that vested in the covered fiscal year $ (2,983,283) $ 937,209 $ 4,632,426 - fair value of as of prior fiscal year end of option awards and stock awards granted in prior fiscal years that failed to meet applicable vesting conditions during the covered fiscal year $ 0 $ 0 $ 0 + dollar value of dividends or earnings paid on option awards or stock awards in the covered fiscal year prior to vesting that are not otherwise included in total compensation $ 0 $ 0 $ 0 Total Equity Adjustments (subtotal)* $ (9,231,569) $ (1,081,503) $ 21,877,775 Compensation Actually Paid $ (4,682,784) $ 7,334,133 $ 24,672,935 * Calculations reflect equity granted over a span of up to seven years of service prior to, as well as during, the reported fiscal years (2016, 2017, 2018, 2019, 2020, 2021, 2022). (5) Cumulative total stockholder return on our shares of common stock from December 31, 2019 through December 31, 2020, December 31, 2021, and December 31, 2022 respectively. Assumes the investment of $100 on December 31, 2019 in our shares of common stock and assumes the reinvestment of dividends, if any, although dividends have never been declared on our shares of common stock. (6) Cumulative total stockholder return on the NASDAQ Biotechnology Index from December 31, 2019 through December 31, 2020, December 31, 2021, and December 31, 2022, respectively. Assumes the investment of $100 on December 31, 2019 in the NASDAQ Biotechnology Index and assumes the reinvestment of dividends. (7) The dollar amounts reported represent the amount of net income reflected in our audited financial statements for the applicable year. (8) The dollar amounts reported represent the amount of total revenue reflected in our audited financial statements for the applicable year. | | |
| Company Selected Measure Name | total revenue | | |
| Named Executive Officers, Footnote [Text Block] | (1) Our PEO for each year reported is Steve Chapman , our Chief Executive Officer. The dollar amounts reported in this column are the amounts of total compensation reported for Mr. Chapman in the “Total” column of the Summary Compensation Table in the applicable fiscal year. (3) The non-PEO NEOs for each year reported are as follows: For 2022: Michael Brophy, Robert Schueren, Daniel Rabinowitz, and Matthew Rabinowitz For 2021: Michael Brophy, Robert Schueren, Daniel Rabinowitz, and Matthew Rabinowitz For 2020: Michael Brophy, Robert Schueren, Matthew Rabinowitz, and Jonathan Sheena The dollar amounts reported in this column represent the average of the amounts reported for the non-PEO NEOs in the “Total” column of the Summary Compensation Table in the applicable fiscal year. | | |
| Peer Group Issuers, Footnote [Text Block] | (6) Cumulative total stockholder return on the NASDAQ Biotechnology Index from December 31, 2019 through December 31, 2020, December 31, 2021, and December 31, 2022, respectively. Assumes the investment of $100 on December 31, 2019 in the NASDAQ Biotechnology Index and assumes the reinvestment of dividends. | | |
| PEO Total Compensation Amount | $ 8,246,281 | $ 23,343,147 | $ 8,083,213 |
| PEO Actually Paid Compensation Amount | $ (10,478,887) | 17,842,930 | 60,865,789 |
| Adjustment To PEO Compensation, Footnote [Text Block] | (2) In accordance with SEC rules, the following adjustments were made to determine the compensation actually paid to our PEO during fiscal years 2022, 2021 and 2020, which consisted solely of adjustments to the PEO’s equity awards: Description of Adjustment 2022 2021 2020 Summary Compensation Table – Total Compensation $ 8,246,281 $ 23,343,147 $ 8,083,213 - grant date fair value of option awards and stock awards granted in the covered fiscal year $ (7,093,675) $ (22,417,562) $ (7,291,047) + fair value at fiscal year end of outstanding and unvested option awards and stock awards granted in the covered fiscal year $ 4,352,420 $ 14,282,938 $ 25,400,473 + change in fair value of outstanding and unvested option awards and stock awards granted in prior fiscal years $ (11,074,522) $ (745,043) $ 21,714,867 + fair value on vesting date of option awards and stock awards granted in the covered fiscal year that vested during the covered fiscal year $ 550,650 $ 0 $ 6,497,053 + change in fair value as of the vesting date of option awards and stock awards granted in prior fiscal years that vested in the covered fiscal year $ (5,460,040) $ 3,379,450 $ 6,461,230 - fair value of as of prior fiscal year end of option awards and stock awards granted in prior fiscal years that failed to meet applicable vesting conditions during the covered fiscal year $ 0 $ 0 $ 0 + dollar value of dividends or earnings paid on option awards or stock awards in the covered fiscal year prior to vesting that are not otherwise included in total compensation $ 0 $ 0 $ 0 Total Equity Adjustments (subtotal)* $ (18,725,167) $ (5,500,217) $ 52,782,576 Compensation Actually Paid $ (10,478,887) $ 17,842,930 $ 60,865,789 * Calculations reflect equity granted over a span of seven years of service prior to, as well as during, the reported fiscal years. | | |
| Non-PEO NEO Average Total Compensation Amount | $ 4,548,786 | 8,415,636 | 2,795,161 |
| Non-PEO NEO Average Compensation Actually Paid Amount | $ (4,682,784) | 7,334,133 | 24,672,935 |
| Adjustment to Non-PEO NEO Compensation Footnote [Text Block] | (4) In accordance with SEC rules, the following adjustments were made to determine the compensation actually paid on average to our non-PEO NEOs during fiscal years 2022, 2021 and 2020, which consisted solely of adjustments to the non-PEO NEOs’ equity awards: Description of Adjustment 2022 2021 2020 Summary Compensation Table – Total Compensation $ 4,548,786 $ 8,415,636 $ 2,795,161 - grant date fair value of option awards and stock awards granted in the covered fiscal year $ (3,982,802) $ (7,808,661) $ (2,262,392) + fair value at fiscal year end of outstanding and unvested option awards and stock awards granted in the covered fiscal year $ 2,256,160 $ 6,278,945 $ 10,304,088 + change in fair value of outstanding and unvested option awards and stock awards granted in prior fiscal years $ (4,777,779) $ (488,996) $ 8,640,852 + fair value on vesting date of option awards and stock awards granted in the covered fiscal year that vested during the covered fiscal year $ 256,134 $ 0 $ 562,800 + change in fair value as of the vesting date of option awards and stock awards granted in prior fiscal years that vested in the covered fiscal year $ (2,983,283) $ 937,209 $ 4,632,426 - fair value of as of prior fiscal year end of option awards and stock awards granted in prior fiscal years that failed to meet applicable vesting conditions during the covered fiscal year $ 0 $ 0 $ 0 + dollar value of dividends or earnings paid on option awards or stock awards in the covered fiscal year prior to vesting that are not otherwise included in total compensation $ 0 $ 0 $ 0 Total Equity Adjustments (subtotal)* $ (9,231,569) $ (1,081,503) $ 21,877,775 Compensation Actually Paid $ (4,682,784) $ 7,334,133 $ 24,672,935 * Calculations reflect equity granted over a span of up to seven years of service prior to, as well as during, the reported fiscal years (2016, 2017, 2018, 2019, 2020, 2021, 2022). | | |
| Compensation Actually Paid vs. Total Shareholder Return [Text Block] | Compensation Actually Paid and Total Stockholder Return The following graph illustrates the relationship between the PEO and average non-PEO NEO “compensation actually paid” (CAP), total compensation from the Summary Compensation Table (SCT), our cumulative Total Stockholder Return (TSR,) and the TSR of the NASDAQ Biotechnology Index, assuming an initial fixed investment of $100, for the fiscal years ended December 31, 2022, 2021 and 2020. The SCT total compensation of our PEO and the average SCT total compensation of our non-PEO NEOs, each as disclosed in the table above, are included in the following graph as supplemental disclosures for each of the periods presented. As detailed in the table above, the CAP calculations include equity adjustments that reflect equity granted over a span of seven years of service prior to, as well as during, the reported fiscal years. A significant portion of our NEOs’ compensation consists of equity awards. As a result, the change between the values disclosed in our SCT and CAP tends to be directionally aligned with changes in our TSR. | | |
| Compensation Actually Paid vs. Net Income [Text Block] | Compensation Actually Paid and Net Income The following graph reflects the relationship between the PEO and average non-PEO NEO CAP and our net income (loss) for the fiscal years ended December 31, 2022, 2021 and 2020. As detailed in the table above, the CAP calculations include equity adjustments that reflect equity granted over a span of seven years of service prior to, as well as during, the reported fiscal years. While we are required by SEC rules to disclose the relationship between our net income and CAP to our NEOs, this is not a metric our compensation committee currently uses in evaluating our NEOs’ compensation. | | |
| Compensation Actually Paid vs. Company Selected Measure [Text Block] | Compensation Actually Paid and Total Revenue The following graph reflects the relationship between the PEO and average non-PEO NEO CAP and our total revenue for the fiscal years ended December 31, 2022, 2021 and 2020. As detailed in the table above, the CAP calculations include equity adjustments that reflect equity granted over a span of seven years of service prior to, as well as during, the reported fiscal years. Our compensation committee views our revenue as an important metric by which to evaluate and measure our performance, and therefore executive performance. As such, total revenue is one of three company financial metrics under our annual cash incentive program, and is weighted the highest of the three, at 55%. In addition, our compensation committee primarily utilizes annual revenue as the performance milestone for performance-based awards under our long-term incentive plan. | | |
| Total Shareholder Return Vs Peer Group [Text Block] | Compensation Actually Paid and Total Stockholder Return The following graph illustrates the relationship between the PEO and average non-PEO NEO “compensation actually paid” (CAP), total compensation from the Summary Compensation Table (SCT), our cumulative Total Stockholder Return (TSR,) and the TSR of the NASDAQ Biotechnology Index, assuming an initial fixed investment of $100, for the fiscal years ended December 31, 2022, 2021 and 2020. The SCT total compensation of our PEO and the average SCT total compensation of our non-PEO NEOs, each as disclosed in the table above, are included in the following graph as supplemental disclosures for each of the periods presented. As detailed in the table above, the CAP calculations include equity adjustments that reflect equity granted over a span of seven years of service prior to, as well as during, the reported fiscal years. A significant portion of our NEOs’ compensation consists of equity awards. As a result, the change between the values disclosed in our SCT and CAP tends to be directionally aligned with changes in our TSR. | | |
| Tabular List [Table Text Block] | Most Important Performance Measures For 2022, the most important performance measures used to inform our executive compensation decisions included the following: ● Total revenue ● Product gross margin ● Operating cash flow | | |
| Total Shareholder Return Amount | $ 119.23 | 277.20 | 295.40 |
| Peer Group Total Shareholder Return Amount | 111.27 | 124.89 | 125.69 |
| Net Income (Loss) | $ (547,799,000) | $ (471,716,000) | $ (229,743,000) |
| Company Selected Measure Amount | 820,222,000 | 625,486,000 | 391,005,000 |
| PEO Name | Steve Chapman | | |
| Measure [Axis]: 1 | | | |
| Pay vs Performance Disclosure [Table] | | | |
| Measure Name | Total revenue | | |
| Non-GAAP Measure Description [Text Block] | (8) The dollar amounts reported represent the amount of total revenue reflected in our audited financial statements for the applicable year. | | |
| Measure [Axis]: 2 | | | |
| Pay vs Performance Disclosure [Table] | | | |
| Measure Name | Product gross margin | | |
| Measure [Axis]: 3 | | | |
| Pay vs Performance Disclosure [Table] | | | |
| Measure Name | Operating cash flow | | |
| PEO [Member] | grant date fair value of option awards and stock awards granted in the covered fiscal year | | | |
| Pay vs Performance Disclosure [Table] | | | |
| Adjustment to Compensation Amount | $ (7,093,675) | $ (22,417,562) | $ (7,291,047) |
| PEO [Member] | fair value at fiscal year end of outstanding and unvested option awards and stock awards granted in the covered fiscal year | | | |
| Pay vs Performance Disclosure [Table] | | | |
| Adjustment to Compensation Amount | 4,352,420 | 14,282,938 | 25,400,473 |
| PEO [Member] | change in fair value of outstanding and unvested option awards and stock awards granted in prior fiscal years | | | |
| Pay vs Performance Disclosure [Table] | | | |
| Adjustment to Compensation Amount | (11,074,522) | (745,043) | 21,714,867 |
| PEO [Member] | fair value on vesting date of option awards and stock awards granted in the covered fiscal year that vested during the covered fiscal year | | | |
| Pay vs Performance Disclosure [Table] | | | |
| Adjustment to Compensation Amount | 550,650 | 0 | 6,497,053 |
| PEO [Member] | change in fair value as of the vesting date of option awards and stock awards granted in prior fiscal years that vested in the covered fiscal year | | | |
| Pay vs Performance Disclosure [Table] | | | |
| Adjustment to Compensation Amount | (5,460,040) | 3,379,450 | 6,461,230 |
| PEO [Member] | fair value of as of prior fiscal year end of option awards and stock awards granted in prior fiscal years that failed to meet applicable vesting conditions during the covered fiscal year | | | |
| Pay vs Performance Disclosure [Table] | | | |
| Adjustment to Compensation Amount | 0 | 0 | 0 |
| PEO [Member] | dollar value of dividends or earnings paid on option awards or stock awards in the covered fiscal year prior to vesting that are not otherwise included in total compensation | | | |
| Pay vs Performance Disclosure [Table] | | | |
| Adjustment to Compensation Amount | 0 | 0 | 0 |
| PEO [Member] | Total Equity Adjustments (subtotal) | | | |
| Pay vs Performance Disclosure [Table] | | | |
| Adjustment to Compensation Amount | (18,725,167) | (5,500,217) | 52,782,576 |
| Non-PEO NEO [Member] | grant date fair value of option awards and stock awards granted in the covered fiscal year | | | |
| Pay vs Performance Disclosure [Table] | | | |
| Adjustment to Compensation Amount | (3,982,802) | (7,808,661) | (2,262,392) |
| Non-PEO NEO [Member] | fair value at fiscal year end of outstanding and unvested option awards and stock awards granted in the covered fiscal year | | | |
| Pay vs Performance Disclosure [Table] | | | |
| Adjustment to Compensation Amount | 2,256,160 | 6,278,945 | 10,304,088 |
| Non-PEO NEO [Member] | change in fair value of outstanding and unvested option awards and stock awards granted in prior fiscal years | | | |
| Pay vs Performance Disclosure [Table] | | | |
| Adjustment to Compensation Amount | (4,777,779) | (488,996) | 8,640,852 |
| Non-PEO NEO [Member] | fair value on vesting date of option awards and stock awards granted in the covered fiscal year that vested during the covered fiscal year | | | |
| Pay vs Performance Disclosure [Table] | | | |
| Adjustment to Compensation Amount | 256,134 | 0 | 562,800 |
| Non-PEO NEO [Member] | change in fair value as of the vesting date of option awards and stock awards granted in prior fiscal years that vested in the covered fiscal year | | | |
| Pay vs Performance Disclosure [Table] | | | |
| Adjustment to Compensation Amount | (2,983,283) | 937,209 | 4,632,426 |
| Non-PEO NEO [Member] | fair value of as of prior fiscal year end of option awards and stock awards granted in prior fiscal years that failed to meet applicable vesting conditions during the covered fiscal year | | | |
| Pay vs Performance Disclosure [Table] | | | |
| Adjustment to Compensation Amount | 0 | 0 | 0 |
| Non-PEO NEO [Member] | dollar value of dividends or earnings paid on option awards or stock awards in the covered fiscal year prior to vesting that are not otherwise included in total compensation | | | |
| Pay vs Performance Disclosure [Table] | | | |
| Adjustment to Compensation Amount | 0 | 0 | 0 |
| Non-PEO NEO [Member] | Total Equity Adjustments (subtotal) | | | |
| Pay vs Performance Disclosure [Table] | | | |
| Adjustment to Compensation Amount | $ (9,231,569) | $ (1,081,503) | $ 21,877,775 |
