Product Sales - Schedule of Sales Related Deductions Activity (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017
SEC Schedule, 12-09, Valuation and Qualifying Accounts Disclosure [Line Items]
Beginning Balance	$ 85,302	$ 45,851
Provisions	344,313	295,977
Credits/payments	(332,525)	(266,527)
Ending Balance	97,090	75,301
Rebates, Chargebacks, and Discounts
SEC Schedule, 12-09, Valuation and Qualifying Accounts Disclosure [Line Items]
Beginning Balance	29,840	12,712
Provisions	159,060	121,599
Credits/payments	(145,813)	(108,811)
Ending Balance	43,087	25,500
Distribution- Related Fees
SEC Schedule, 12-09, Valuation and Qualifying Accounts Disclosure [Line Items]
Beginning Balance	34,142	29,465
Provisions	155,523	140,860
Credits/payments	(150,956)	(136,272)
Ending Balance	38,709	34,053
Other Sales- Related Deductions
SEC Schedule, 12-09, Valuation and Qualifying Accounts Disclosure [Line Items]
Beginning Balance	21,320	3,674
Provisions	29,730	33,518
Credits/payments	(35,756)	(21,444)
Ending Balance	$ 15,294	$ 15,748