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Certain Balance Sheet Items - Accrued Liabilities (Details) - USD ($)
$ in Thousands
Sep. 30, 2019
Jan. 01, 2019
Dec. 31, 2018
Certain Balance Sheet Items [Abstract]      
Rebates and other sales deductions $ 86,191   $ 86,495
Employee compensation and benefits 64,595   58,543
Current portion of operating lease liabilities 11,713    
Inventory-related accruals 10,433   8,753
Clinical trial accruals 7,973   5,904
Selling and marketing accruals 6,705   6,780
Royalties 6,074   2,679
Professional fees 4,213   2,333
Accrued construction-in-progress 3,070   1,065
Sales returns reserve 2,872   2,510
Accrued interest 2,539   7,407
Derivative instrument liabilities 2,427   1,460
Accrued loss contingency 0   58,154
Other 29,935   22,804
Total accrued liabilities $ 238,740 $ 273,052 $ 264,887