Income Taxes - Reconciliation of Tax Rate (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Effective Income Tax Rate Reconciliation, Percent [Abstract]
Statutory tax rate	12.50%	12.50%	12.50%
Differences in international tax rates	(34.50%)	3.20%	8.00%
Nondeductible changes in fair value of contingent consideration	(19.40%)	(0.30%)	4.00%
Intercompany asset transfer	0.00%	21.20%	0.00%
Change in valuation allowances	(83.30%)	(19.10%)	(5.30%)
Nondeductible stock-based compensation	(20.90%)	(2.70%)	(1.30%)
Hospital Products sale	183.50%	0.00%	0.00%
Unrealized tax benefits	5.40%	0.70%	(1.30%)
State and local taxes (net of federal)	(0.40%)	0.00%	(0.30%)
Change in U.S. tax law	179.50%	0.00%	(0.20%)
Nondeductible interest expense	(34.00%)	(2.50%)	(1.10%)
Orphan drug and R&D tax credit	55.00%	0.00%	0.00%
Other	(5.10%)	0.90%	0.70%
Effective income tax rate	238.30%	13.90%	15.70%
Effective Income Tax Rate Reconciliation, Amount [Abstract]
Income tax benefit - at statutory tax rate	$ (636)	$ (4,823)	$ (14,149)
Differences in international tax rates	1,755	(1,218)	(9,039)
Nondeductible changes in fair value of contingent consideration	988	121	(4,559)
Intercompany asset transfer	0	(8,190)	0
Change in valuation allowances	4,231	7,379	5,998
Nondeductible stock-based compensation	1,060	1,039	1,499
Hospital Products sale	(9,328)	0	0
Unrecognized tax benefits	(274)	(261)	1,440
State and local taxes (net of federal)	20	(7)	299
Change in U.S. tax law	(9,124)	0	274
Nondeductible interest expense	1,728	982	1,269
Orphan drug and R&D tax credit	(2,793)	0	0
Other	263	(378)	(925)
Income tax benefit	$ (12,110)	$ (5,356)	$ (17,893)