CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Cash flows from operating activities of continuing operations:
Net income	$ 152,530	$ 237,841	$ 245,713
Adjustments to reconcile net income to net cash provided by operating activities:
Loss (income) from discontinued operations	2,733	(190)	(8,905)
Depreciation expense	56,497	54,415	46,013
Amortization expense of intangible assets	98,766	63,491	62,380
Amortization expense of deferred financing costs and debt discount	5,075	10,440	16,941
Loss on extinguishment of debt	5,593	19,261	10,454
Fair value step up of acquired inventory sold	10,442	0	0
Changes in contingent consideration	3,575	(6,445)	(4,576)
Impairment of long-lived assets	0	2,356	0
In-process research and development impairment charge	0	41,000	0
Stock-based compensation	19,407	16,871	14,467
Net gain on sales of businesses and assets	0	(4,367)	(408)
Deferred income taxes, net	(41,822)	(29,346)	(54,413)
Other	(18,469)	(13,311)	(20,775)
Changes in operating assets and liabilities, net of effects of acquisitions and disposals:
Accounts receivable	(11,039)	(11,029)	398
Inventories	(22,363)	6,408	(8,371)
Prepaid expenses and other current assets	547	(3,613)	(3,027)
Accounts payable and accrued expenses	39,001	15,422	(117)
Income taxes receivable and payable, net	125,828	11,386	7,672
Net cash provided by operating activities from continuing operations	426,301	410,590	303,446
Cash flows from investing activities of continuing operations:
Expenditures for property, plant and equipment	(70,903)	(53,135)	(61,448)
Payments for businesses and intangibles acquired, net of cash acquired	(1,768,284)	(14,040)	(93,808)
Proceeds from sales of businesses and assets	6,332	10,201	408
Net cash used in investing activities from continuing operations	(1,832,855)	(56,974)	(154,848)
Cash flows from financing activities of continuing operations:
Proceeds from new borrowings	2,463,500	671,700	288,100
Reduction in borrowings	(1,239,576)	(714,565)	(303,757)
Debt extinguishment, issuance and amendment fees	(26,664)	(8,958)	(9,017)
Proceeds from share based compensation plans and the related tax impacts	5,571	9,068	4,994
Payments to noncontrolling interest shareholders	0	(464)	(1,343)
Payments for acquisition of noncontrolling interest	0	(9,231)	0
Payments for contingent consideration	(335)	(7,282)	(8,028)
Dividends	(61,237)	(58,960)	(56,532)
Net cash provided by (used in) financing activities from continuing operations	1,141,259	(118,692)	(85,583)
Cash flows from discontinued operations:
Net cash used in operating activities	(6,416)	(2,110)	(2,636)
Net cash used in discontinued operations	(6,416)	(2,110)	(2,636)
Effect of exchange rate changes on cash and cash equivalents	61,480	(27,391)	(25,249)
Net (decrease) increase in cash and cash equivalents	(210,231)	205,423	35,130
Cash and cash equivalents at the beginning of the year	543,789	338,366	303,236
Cash and cash equivalents at the end of the year	333,558	543,789	338,366
Supplemental cash flow information:
Cash interest paid	74,256	44,203	45,973
Income taxes paid, net of refunds	49,144	23,955	56,079
Non cash investing and financing activities of continuing operations:
Purchases of businesses and related costs	261,733	0	0
Settlement and exchange of convertible notes with common or treasury stock	53,207	35,286	133
Acquisition of treasury stock from settlement and exchange of convertible note hedge and warrants	$ 141,405	$ 86,046	$ 269