Income Taxes - Schedule of effective income tax rate reconciliation (Details)	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Income Tax Disclosure [Abstract]
U.S. federal statutory tax rate	21.00%	35.00%	35.00%
Impact of change in U.S. corporate tax rate (the Act)	(2.70%)	15.70%	0.00%
Sale of non-inventory related assets between foreign subsidiaries	(6.30%)	0.00%	0.00%
Stock-based compensation	(2.50%)	(9.00%)	(10.90%)
Taxation of non-U.S. operations	(1.90%)	0.70%	8.80%
Income tax credits	(2.60%)	(1.30%)	(1.20%)
Non-deductible Branded Prescription Drug Fee	0.60%	1.70%	1.90%
Foreign-derived intangible income deduction	(1.00%)	(0.00%)	(0.00%)
Domestic production activities deduction	(0.00%)	(2.60%)	(2.80%)
State and local income taxes	0.10%	0.10%	1.30%
Other permanent differences	(0.40%)	2.00%	0.60%
Effective income tax rate	4.30%	42.30%	32.70%