Fair Value Measurements - Contingent Consideration (Details)	3 Months Ended		12 Months Ended
	Jun. 30, 2018 USD ($)	Sep. 30, 2017 USD ($)	Dec. 31, 2018 USD ($)	Dec. 31, 2017 USD ($)	Dec. 31, 2016 USD ($)
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Contingent consideration accrued			$ 129,537,000	$ 166,732,000
Reconciliation of contingent consideration obligations related to acquisitions
Royalty payment			119,000	39,793,000	$ 92,130,000
Endoceutics License Agreement
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Contingent consideration accrued			0	10,000,000
MuGard
Reconciliation of contingent consideration obligations related to acquisitions
Royalty payment				200,000
Estimated undiscounted royalty amounts payable, minimum			300,000
Estimated undiscounted royalty amounts payable, maximum			$ 600,000
Period over which estimated undiscounted royalty amounts could be paid			10 years
Contingent Consideration
Reconciliation of contingent consideration obligations related to acquisitions
Balance			$ 50,085,000	147,995,000
Payments made			(119,000)	(50,224,000)
Adjustments to fair value of contingent consideration	$ 49,800,000	$ 49,900,000	(49,607,000)	(47,686,000)
Balance			$ 359,000	50,085,000	$ 147,995,000
Lumara Health
Reconciliation of contingent consideration obligations related to acquisitions
Payment of contingent consideration				$ 50,000,000
Measurement Input, Discount Rate | MuGard
Reconciliation of contingent consideration obligations related to acquisitions
Discount rate			0.14