Goodwill and other intangible assets - components of intangible assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 3,033,706	$ 2,964,632
Accumulated Amortization	(708,654)	(580,884)
Customer relationships
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	1,030,194	1,023,837
Accumulated Amortization	(322,972)	(281,263)
In-process research and development
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	28,457	34,672
Accumulated Amortization	0	0
Intellectual property
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	1,363,516	1,287,487
Accumulated Amortization	(322,539)	(258,580)
Distribution rights
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	23,465	23,697
Accumulated Amortization	(17,860)	(16,996)
Trade names
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	565,070	571,510
Accumulated Amortization	(36,379)	(22,069)
Non-compete agreements
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	23,004	23,429
Accumulated Amortization	$ (8,904)	$ (1,976)