Accounts Payable and Accrued Expenses (Details) - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016
Accounts Payable and Accrued Liabilities, Current [Abstract]
Accounts payable	$ 153,946	$ 134,984
Accrued payroll and related costs	166,102	153,086
Accrued clinical trial expense	119,608	91,753
Accrued sales-related charges, deductions and royalties	167,467	159,985
Taxes Payable, Current	126,612	235,776
Other accrued expenses and liabilities	84,691	103,512
Accounts payable and accrued expenses	$ 818,426	$ 879,096