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Revenue Recognition (Tables)
 9 Months Ended
Sep. 30, 2019
Revenue from Contract with Customer [Abstract]  
Disaggregated revenue
The following table provides information about disaggregated revenue by products for the three and nine months ended September 30, 2019 and 2018 (in thousands):
 
Three Months Ended September 30,
 
Nine Months Ended September 30,
 
2019
 
2018
 
2019
 
2018
Product sales, net
 
 
 
 
 
 
 
Feraheme
$
44,205

 
$
36,963

 
$
126,294

 
$
99,796

Makena
34,272

 
80,221

 
96,464

 
275,377

Intrarosa
5,607

 
4,925

 
14,898

 
10,331

Other
23

 
129

 
156

 
302

Total product sales, net
$
84,107

 
$
122,238

 
$
237,812

 
$
385,806


Total gross product sales were offset by product sales allowances and accruals for the three and nine months ended September 30, 2019 and 2018 as follows (in thousands):
 
Three Months Ended September 30,
 
Nine Months Ended September 30,
 
2019
 
2018
 
2019
 
2018
Gross product sales
$
254,073

 
$
238,856

 
$
704,976

 
$
776,458

Provision for product sales allowances and accruals:
 

 
 

 
 

 
 

Contractual adjustments
144,108

 
93,213

 
381,633

 
290,896

Governmental rebates
25,858

 
23,405

 
85,531

 
99,756

Total
169,966

 
116,618

 
467,164

 
390,652

Product sales, net
$
84,107

 
$
122,238

 
$
237,812

 
$
385,806
Product revenue allowance and accrual activity
The following table summarizes the product revenue allowance and accrual activity for the three and nine months ended September 30, 2019 (in thousands):
 
Contractual
 
Governmental
 
 
 
Adjustments
 
Rebates
 
Total
Balance at December 31, 2018
$
57,199

 
$
29,114

 
$
86,313

Provisions related to current period sales
233,305

 
44,539

 
277,844

Adjustments related to prior period sales
4,200

 
15,134

 
19,334

Payments/returns relating to current period sales
(176,392
)
 
(11,909
)
 
(188,301
)
Payments/returns relating to prior period sales
(40,538
)
 
(36,362
)
 
(76,900
)
Balance at June 30, 2019
$
77,774

 
$
40,516

 
$
118,290

Provisions related to current period sales
139,697

 
27,296

 
166,993

Adjustments related to prior period sales
4,475

 
(1,438
)
 
3,037

Payments/returns relating to current period sales
(117,780
)
 
(4,899
)
 
(122,679
)
Payments/returns relating to prior period sales
(20,239
)
 
(2,611
)
 
(22,850
)
Balance at September 30, 2019
$
83,927

 
$
58,864

 
$
142,791