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Revenue Recognition (Tables)
 12 Months Ended
Dec. 31, 2018
Revenue from Contract with Customer [Abstract]  
Disaggregated revenue
The following table provides information about disaggregated revenue by products for the years ended December 31, 2018, 2017 and 2016 (in thousands):
 
Years Ended December 31,
 
2018
 
2017
 
2016
Product sales, net
 
 
 
 
 
Makena
$
322,265

 
$
387,158

 
$
334,050

Feraheme
135,001

 
105,930

 
97,058

Intrarosa
16,218

 
1,816

 
—

MuGard
368

 
741

 
1,062

Total
$
473,852

 
$
495,645

 
$
432,170


Total gross product sales were offset by product sales allowances and accruals for the years ended December 31, 2018, 2017 and 2016 as follows (in thousands):
 
Years Ended December 31,
 
2018
 
2017
 
2016
Gross product sales
$
974,330

 
$
920,061

 
$
748,839

Provision for product sales allowances and accruals:
 
 
 
 
 
Contractual adjustments
387,540

 
310,588

 
229,686

Governmental rebates
112,938

 
113,828

 
86,983

Total
500,478

 
424,416

 
316,669

Product sales, net
$
473,852

 
$
495,645

 
$
432,170
Product revenue allowance and accrual activity
The following table summarizes the product revenue allowance and accrual activity for the years ended December 31, 2018, 2017 and 2016 (in thousands):

 
Contractual
 
Governmental
 
 
 
Adjustments
 
Rebates
 
Total
Balance at January 1, 2016
$
30,177

 
$
25,767

 
$
55,944

Current provisions relating to sales in current year
224,894

 
93,035

 
317,929

Adjustments relating to sales in prior years
(2,348
)
 
(6,052
)
 
(8,400
)
Payments/returns relating to sales in current year
(181,150
)
 
(41,636
)
 
(222,786
)
Payments/returns relating to sales in prior years
(23,973
)
 
(19,715
)
 
(43,688
)
Balance at December 31, 2016
47,600

 
51,399

 
98,999

Current provisions relating to sales in current year
314,537

 
112,167

 
426,704

Adjustments relating to sales in prior years
(3,949
)
 
1,661

 
(2,288
)
Payments/returns relating to sales in current year
(253,545
)
 
(61,569
)
 
(315,114
)
Payments/returns relating to sales in prior years
(42,479
)
 
(53,060
)
 
(95,539
)
Balance at December 31, 2017
62,164

 
50,598

 
112,762

Provisions related to current period sales
389,861

 
105,034

 
494,895

Adjustments related to prior period sales
(2,330
)
 
7,903

 
5,573

Payments/returns relating to current period sales
(333,694
)
 
(75,920
)
 
(409,614
)
Payments/returns relating to prior period sales
(58,802
)
 
(58,501
)
 
(117,303
)
Balance at December 31, 2018
$
57,199

 
$
29,114

 
$
86,313