Revenue Recognition - Product Revenue Allowance and Accrual Activity (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Mar. 31, 2019	Jun. 30, 2019
Contractual Adjustments
Balance at Beginning of Period	$ 73,013	$ 57,199	$ 57,199
Provisions related to current period sales	125,917	107,388
Adjustments related to prior period sales	2,660	1,540	4,200
Payments/returns relating to current period sales	(110,553)	(65,839)
Payments/returns relating to prior period sales	(13,263)	(27,275)
Balance at End of Period	77,774	73,013	77,774
Governmental Rebates
Balance at Beginning of Period	41,927	29,114	29,114
Provisions related to current period sales	26,037	18,502
Adjustments related to prior period sales	6,531	8,603	15,100
Payments/returns relating to current period sales	(11,909)	0
Payments/returns relating to prior period sales	(22,070)	(14,292)
Balance at End of Period	40,516	41,927	40,516
Revenue, Allowance [Roll Forward]
Balance at Beginning of Period	114,940	86,313	86,313
Provisions related to current period sales	151,954	125,890
Adjustments related to prior period sales	9,191	10,143
Payments/returns relating to current period sales	(122,462)	(65,839)
Payments/returns relating to prior period sales	(35,333)	(41,567)
Balance at End of Period	$ 118,290	$ 114,940	$ 118,290