Revenue Recognition - Total Gross Product (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Provision for product sales allowances and accruals:
Revenues	$ 84,131	$ 122,238	$ 238,043	$ 385,881
Product Revenue
Disaggregation of Revenue [Line Items]
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
Revenues	$ 84,107	$ 122,238	$ 237,812	$ 385,806