Revenue Recognition - Product Revenue Allowance and Accrual Activity (Details) - USD ($) $ in Thousands	3 Months Ended	6 Months Ended	9 Months Ended
	Sep. 30, 2019	Jun. 30, 2019	Sep. 30, 2019
Contractual Adjustments
Balance at Beginning of Period	$ 77,774	$ 57,199	$ 57,199
Provisions related to current period sales	139,697	233,305
Adjustments related to prior period sales	4,475	4,200	8,700
Payments/returns relating to current period sales	(117,780)	(176,392)
Payments/returns relating to prior period sales	(20,239)	(40,538)
Balance at End of Period	83,927	77,774	83,927
Governmental Rebates
Balance at Beginning of Period	40,516	29,114	29,114
Provisions related to current period sales	27,296	44,539
Adjustments related to prior period sales	(1,438)	15,134	13,700
Payments/returns relating to current period sales	(4,899)	(11,909)
Payments/returns relating to prior period sales	(2,611)	(36,362)
Balance at End of Period	58,864	40,516	58,864
Revenue, Allowance [Roll Forward]
Balance at Beginning of Period	118,290	86,313	86,313
Provisions related to current period sales	166,993	277,844
Adjustments related to prior period sales	3,037	19,334
Payments/returns relating to current period sales	(122,679)	(188,301)
Payments/returns relating to prior period sales	(22,850)	(76,900)
Balance at End of Period	$ 142,791	$ 118,290	$ 142,791