Revenue Recognition - Total Gross Product Sales Offset by Product Sales Allowance and Accruals (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Provision for product sales allowances and accruals:
Revenues	$ 93,106	$ 83,808	$ 210,637	$ 237,062
Product Revenue
Disaggregation of Revenue [Line Items]
Gross product sales	218,739	254,073	633,475	704,976
Provision for product sales allowances and accruals:
Contractual adjustments	129,966	144,108	383,003	381,633
Governmental rebates	15,544	26,181	59,770	86,512
Total	145,510	170,289	442,773	468,145
Revenues	$ 73,229	$ 83,784	$ 190,702	$ 236,831