Revenue Recognition - Total Gross Product (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Provision for product sales allowances and accruals:
Revenues	$ 78,109	$ 146,254	$ 153,913	$ 263,642
Product Revenue
Disaggregation of Revenue [Line Items]
Gross product sales	239,185	297,732	450,904	537,602
Provision for product sales allowances and accruals:
Contractual adjustments	128,641	111,539	237,526	197,683
Governmental rebates	32,568	39,974	59,673	76,352
Total	161,209	151,513	297,199	274,035
Revenues	$ 77,976	$ 146,219	$ 153,705	$ 263,567