Product Sales Schedule of Sales Related Deductions Activity (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017
SEC Schedule, 12-09, Valuation and Qualifying Accounts Disclosure [Line Items]
Beginning Balance	$ 85,302	$ 45,851
Provisions	219,723	188,858
Credits/payments	(214,071)	(179,681)
Ending Balance	90,954	55,028
Rebates, Chargebacks, and Discounts
SEC Schedule, 12-09, Valuation and Qualifying Accounts Disclosure [Line Items]
Beginning Balance	29,840	12,712
Provisions	97,698	78,250
Credits/payments	(91,108)	(67,850)
Ending Balance	36,430	23,112
Distribution- Related Fees
SEC Schedule, 12-09, Valuation and Qualifying Accounts Disclosure [Line Items]
Beginning Balance	34,142	29,465
Provisions	102,133	90,077
Credits/payments	(98,532)	(90,519)
Ending Balance	37,743	29,023
Other Sales- Related Deductions
SEC Schedule, 12-09, Valuation and Qualifying Accounts Disclosure [Line Items]
Beginning Balance	21,320	3,674
Provisions	19,892	20,531
Credits/payments	(24,431)	(21,312)
Ending Balance	$ 16,781	$ 2,893