Share-Based Compensation - Expense (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Total share-based compensation expense, pre-tax	$ 28,785	$ 25,103	$ 84,626	$ 75,718
Income tax benefit from share-based compensation expense	(4,106)	(3,552)	(12,246)	(12,066)
Total share-based compensation expense, net of tax	24,679	21,551	72,380	63,652
Selling, general and administrative
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Total share-based compensation expense, pre-tax	20,302	18,978	61,357	57,012
Research and development
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Total share-based compensation expense, pre-tax	6,498	4,600	17,917	13,684
Cost of product sales
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Total share-based compensation expense, pre-tax	$ 1,985	$ 1,525	$ 5,352	$ 5,022