Fair Value Measurements Level 3 Unobservable Input Reconciliation (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018	Dec. 31, 2018
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Fair Value, Measurement with Unobservable Inputs Reconciliation, Recurring Basis, Liability, Settlements			$ 1,071
Change in fair value of acquired royalty rights, Level 3 Rollforward	$ (40,399)	$ 12,842	(28,142)	$ 23,933
Payments for (Proceeds from) Productive Assets			(32,726)	(37,993)
Change in fair value included in earnings for liabilities	0	$ 22,135	0	$ 22,735
Contingent Consideration [Member]
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Fair Value, Measurement with Unobservable Inputs Reconciliation, Recurring Basis, Liability Value	0		0		$ (1,071)
Royalty right [Member]
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Beginning balance			376,510
Change in fair value of acquired royalty rights, Level 3 Rollforward			(28,142)
Ending balance	315,642		315,642
Payments for (Proceeds from) Productive Assets			(32,726)
Fair Value, Measurement with Unobservable Inputs Reconciliation, Recurring Basis, Asset, Gain (Loss) Included in Earnings			(60,868)
Depomed [Member] | Royalty right [Member]
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Beginning balance			264,371
Ending balance	$ 263,912		263,912
Fair Value, Measurement with Unobservable Inputs Reconciliation, Recurring Basis, Asset, Gain (Loss) Included in Earnings			$ (459)
VB [Member]
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Long-Duration Contracts, Assumptions by Product and Guarantee, Discount Rate	15.00%		15.00%
VB [Member] | Royalty right [Member]
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Beginning balance			$ 14,108
Ending balance	$ 14,373		14,373
Fair Value, Measurement with Unobservable Inputs Reconciliation, Recurring Basis, Asset, Gain (Loss) Included in Earnings			$ 265
University of Michigan [Member]
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Long-Duration Contracts, Assumptions by Product and Guarantee, Discount Rate	12.80%		12.80%
University of Michigan [Member] | Royalty right [Member]
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Beginning balance			$ 25,595
Ending balance	$ 24,279		24,279
Fair Value, Measurement with Unobservable Inputs Reconciliation, Recurring Basis, Asset, Gain (Loss) Included in Earnings			$ (1,316)
AcelRx [Member]
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Long-Duration Contracts, Assumptions by Product and Guarantee, Discount Rate	13.40%		13.40%
AcelRx [Member] | Royalty right [Member]
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Beginning balance			$ 70,380
Ending balance	$ 12,494		12,494
Fair Value, Measurement with Unobservable Inputs Reconciliation, Recurring Basis, Asset, Gain (Loss) Included in Earnings	$ (59,974)		$ (57,886)
Kybella [Member]
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Long-Duration Contracts, Assumptions by Product and Guarantee, Discount Rate	14.40%		14.40%
Kybella [Member] | Royalty right [Member]
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Beginning balance			$ 2,056
Ending balance	$ 584		584
Fair Value, Measurement with Unobservable Inputs Reconciliation, Recurring Basis, Asset, Gain (Loss) Included in Earnings			$ (1,472)
CareView [Member] | Note receivable cash flows [Member]
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Long-Duration Contracts, Assumptions by Product and Guarantee, Discount Rate	30.00%		30.00%		30.00%
Measurement Input, Discount Rate [Member] | Other [Member] | Wellstat Diagnostics [Member]
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Beginning balance			$ 34,000
Ending balance	$ 34,000		34,000
Measurement Input, Discount Rate [Member] | Intellectual Property [Member] | Wellstat Diagnostics [Member]
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Beginning balance			21,000
Ending balance	$ 21,000		$ 21,000