Goodwill and other intangible assets, net - Components of intangible assets (Details) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Finite-Lived Intangible Assets [Line Items]
Gross carrying amount	$ 3,018,607	$ 3,033,706
Accumulated Amortization	(744,119)	(708,654)
In-process research and development
Finite-Lived Intangible Assets [Line Items]
In-process research and development	28,137	28,457
Accumulated Amortization	0	0
Customer relationships
Finite-Lived Intangible Assets [Line Items]
Finite-lived intangible assets	1,022,131	1,030,194
Accumulated Amortization	(333,633)	(322,972)
Intellectual property
Finite-Lived Intangible Assets [Line Items]
Finite-lived intangible assets	1,358,049	1,363,516
Accumulated Amortization	(341,986)	(322,539)
Distribution rights
Finite-Lived Intangible Assets [Line Items]
Finite-lived intangible assets	23,405	23,465
Accumulated Amortization	(18,075)	(17,860)
Trade names
Finite-Lived Intangible Assets [Line Items]
Finite-lived intangible assets	564,045	565,070
Accumulated Amortization	(39,904)	(36,379)
Non-compete agreements
Finite-Lived Intangible Assets [Line Items]
Finite-lived intangible assets	22,840	23,004
Accumulated Amortization	$ (10,521)	$ (8,904)