Revenue Recognition - Total Gross Product (Details) - USD ($) $ in Thousands	3 Months Ended
Mar. 31, 2019	Mar. 31, 2018
Provision for product sales allowances and accruals:
Revenues	$ 75,804	$ 117,387
Product Revenue
Disaggregation of Revenue [Line Items]
Gross product sales	211,718	239,870
Provision for product sales allowances and accruals:
Contractual adjustments	108,884	86,144
Governmental rebates	27,105	36,378
Total	135,989	122,522
Revenues	$ 75,729	$ 117,348

Amount, excluding tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value added and excise.

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 4
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=109196051&loc=SL49130543-203045

Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 1
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=109196051&loc=SL49130539-203045

Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 5
-URI http://asc.fasb.org/extlink&oid=109196051&loc=SL49130545-203045

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Data Type:	xbrli:monetaryItemType
Balance Type:	credit
Period Type:	duration