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Commitments and contingencies - Registration Payment Arrangement (Details)
Nov. 05, 2018
USD ($)
item
$ / shares
Jun. 01, 2017
USD ($)
Dec. 31, 2018
USD ($)
Second Amendment Facility Due in May 2020 | Debt issued to entities affiliated with Deerfield | Common Stock      
Registration Payment Arrangement      
Conversion price | $ / shares $ 10.00    
Second Amendment Facility Due in May 2020 | Debt issued to entities affiliated with Deerfield | Common Stock | Maximum      
Registration Payment Arrangement      
Number of shares which may be issued for conversion of convertible notes | item 3,796,668    
Registration Agreement | Senior Secured Convertible Notes      
Registration Payment Arrangement      
Time period after date of any Registration Failure during which additional damages are required to be paid 30 days    
Additional damages payable upon any Registration Failure, as percent of original principal amount of debt 2.00%    
Maximum reimbursable legal fees $ 25,000    
Registration Agreement | Senior Secured Credit Facility      
Registration Payment Arrangement      
Maximum reimbursable legal fees   $ 25,000  
Liability recorded for expected unmet agreement obligations     $ 0