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Segment and Geographic Information (Details) (USD $)
In Thousands, unless otherwise specified
3 Months Ended 12 Months Ended
Dec. 31, 2014
Sep. 30, 2014
Jun. 30, 2014
Mar. 31, 2014
Dec. 31, 2013
Sep. 30, 2013
Jun. 30, 2013
Mar. 31, 2013
Dec. 31, 2014
segment
Dec. 31, 2013
Dec. 31, 2012
Revenues from External Customers and Long-Lived Assets [Line Items]                      
Number of operating segment                 1mdco_NumberOfOperatingSegment    
Net revenue $ 190,998us-gaap_SalesRevenueNet [1],[2] $ 172,401us-gaap_SalesRevenueNet $ 183,774us-gaap_SalesRevenueNet [1] $ 177,235us-gaap_SalesRevenueNet $ 185,003us-gaap_SalesRevenueNet [3] $ 174,282us-gaap_SalesRevenueNet $ 172,826us-gaap_SalesRevenueNet $ 155,753us-gaap_SalesRevenueNet [4] $ 724,408us-gaap_SalesRevenueNet $ 687,864us-gaap_SalesRevenueNet $ 558,588us-gaap_SalesRevenueNet
Long-lived assets 1,227,284us-gaap_NoncurrentAssets       1,148,267us-gaap_NoncurrentAssets       1,227,284us-gaap_NoncurrentAssets 1,148,267us-gaap_NoncurrentAssets  
United States [Member]                      
Revenues from External Customers and Long-Lived Assets [Line Items]                      
Net revenue                 687,830us-gaap_SalesRevenueNet
/ us-gaap_StatementGeographicalAxis
= country_US
629,459us-gaap_SalesRevenueNet
/ us-gaap_StatementGeographicalAxis
= country_US
512,044us-gaap_SalesRevenueNet
/ us-gaap_StatementGeographicalAxis
= country_US
Percentage of revenue by geographic segments                 95.00%mdco_PercentageOfRevenueByGeographicSegment
/ us-gaap_StatementGeographicalAxis
= country_US
91.50%mdco_PercentageOfRevenueByGeographicSegment
/ us-gaap_StatementGeographicalAxis
= country_US
91.70%mdco_PercentageOfRevenueByGeographicSegment
/ us-gaap_StatementGeographicalAxis
= country_US
Long-lived assets 1,218,370us-gaap_NoncurrentAssets
/ us-gaap_StatementGeographicalAxis
= country_US
      1,139,210us-gaap_NoncurrentAssets
/ us-gaap_StatementGeographicalAxis
= country_US
      1,218,370us-gaap_NoncurrentAssets
/ us-gaap_StatementGeographicalAxis
= country_US
1,139,210us-gaap_NoncurrentAssets
/ us-gaap_StatementGeographicalAxis
= country_US
 
Percentage of long-lived assets by geographic segments 99.30%mdco_PercentageOfLongLivedAssetsByGeographicSegment
/ us-gaap_StatementGeographicalAxis
= country_US
      99.20%mdco_PercentageOfLongLivedAssetsByGeographicSegment
/ us-gaap_StatementGeographicalAxis
= country_US
      99.30%mdco_PercentageOfLongLivedAssetsByGeographicSegment
/ us-gaap_StatementGeographicalAxis
= country_US
99.20%mdco_PercentageOfLongLivedAssetsByGeographicSegment
/ us-gaap_StatementGeographicalAxis
= country_US
 
Europe [Member]                      
Revenues from External Customers and Long-Lived Assets [Line Items]                      
Net revenue                 32,859us-gaap_SalesRevenueNet
/ us-gaap_StatementGeographicalAxis
= us-gaap_EuropeMember
50,419us-gaap_SalesRevenueNet
/ us-gaap_StatementGeographicalAxis
= us-gaap_EuropeMember
38,517us-gaap_SalesRevenueNet
/ us-gaap_StatementGeographicalAxis
= us-gaap_EuropeMember
Percentage of revenue by geographic segments                 4.50%mdco_PercentageOfRevenueByGeographicSegment
/ us-gaap_StatementGeographicalAxis
= us-gaap_EuropeMember
7.30%mdco_PercentageOfRevenueByGeographicSegment
/ us-gaap_StatementGeographicalAxis
= us-gaap_EuropeMember
6.90%mdco_PercentageOfRevenueByGeographicSegment
/ us-gaap_StatementGeographicalAxis
= us-gaap_EuropeMember
Long-lived assets 8,899us-gaap_NoncurrentAssets
/ us-gaap_StatementGeographicalAxis
= us-gaap_EuropeMember
      9,035us-gaap_NoncurrentAssets
/ us-gaap_StatementGeographicalAxis
= us-gaap_EuropeMember
      8,899us-gaap_NoncurrentAssets
/ us-gaap_StatementGeographicalAxis
= us-gaap_EuropeMember
9,035us-gaap_NoncurrentAssets
/ us-gaap_StatementGeographicalAxis
= us-gaap_EuropeMember
 
Percentage of long-lived assets by geographic segments 0.70%mdco_PercentageOfLongLivedAssetsByGeographicSegment
/ us-gaap_StatementGeographicalAxis
= us-gaap_EuropeMember
      0.80%mdco_PercentageOfLongLivedAssetsByGeographicSegment
/ us-gaap_StatementGeographicalAxis
= us-gaap_EuropeMember
      0.70%mdco_PercentageOfLongLivedAssetsByGeographicSegment
/ us-gaap_StatementGeographicalAxis
= us-gaap_EuropeMember
0.80%mdco_PercentageOfLongLivedAssetsByGeographicSegment
/ us-gaap_StatementGeographicalAxis
= us-gaap_EuropeMember
 
Other [Member]                      
Revenues from External Customers and Long-Lived Assets [Line Items]                      
Net revenue                 3,719us-gaap_SalesRevenueNet
/ us-gaap_StatementGeographicalAxis
= mdco_RestOfWorldMember
7,986us-gaap_SalesRevenueNet
/ us-gaap_StatementGeographicalAxis
= mdco_RestOfWorldMember
8,027us-gaap_SalesRevenueNet
/ us-gaap_StatementGeographicalAxis
= mdco_RestOfWorldMember
Percentage of revenue by geographic segments                 0.50%mdco_PercentageOfRevenueByGeographicSegment
/ us-gaap_StatementGeographicalAxis
= mdco_RestOfWorldMember
1.20%mdco_PercentageOfRevenueByGeographicSegment
/ us-gaap_StatementGeographicalAxis
= mdco_RestOfWorldMember
1.40%mdco_PercentageOfRevenueByGeographicSegment
/ us-gaap_StatementGeographicalAxis
= mdco_RestOfWorldMember
Long-lived assets $ 15us-gaap_NoncurrentAssets
/ us-gaap_StatementGeographicalAxis
= mdco_RestOfWorldMember
      $ 22us-gaap_NoncurrentAssets
/ us-gaap_StatementGeographicalAxis
= mdco_RestOfWorldMember
      $ 15us-gaap_NoncurrentAssets
/ us-gaap_StatementGeographicalAxis
= mdco_RestOfWorldMember
$ 22us-gaap_NoncurrentAssets
/ us-gaap_StatementGeographicalAxis
= mdco_RestOfWorldMember
 
Percentage of long-lived assets by geographic segments 0.00%mdco_PercentageOfLongLivedAssetsByGeographicSegment
/ us-gaap_StatementGeographicalAxis
= mdco_RestOfWorldMember
      0.00%mdco_PercentageOfLongLivedAssetsByGeographicSegment
/ us-gaap_StatementGeographicalAxis
= mdco_RestOfWorldMember
      0.00%mdco_PercentageOfLongLivedAssetsByGeographicSegment
/ us-gaap_StatementGeographicalAxis
= mdco_RestOfWorldMember
0.00%mdco_PercentageOfLongLivedAssetsByGeographicSegment
/ us-gaap_StatementGeographicalAxis
= mdco_RestOfWorldMember
 
[1] Net loss for the second and fourth quarters of 2014 includes impairment charges on product licenses in the amount of $15.1 million and $6.4 million, respectively to cost of sales, as a result of reductions in estimated future cash flows expected to be generated by the acute care generic products as determined by an updated discounted cash flow analysis (Level 3).
[2] In December 2014, the Company entered into a settlement and amendment to the merger agreement with Incline Therapeutics, Inc., which resulted in revisions to certain milestone triggers, a reduction in total milestone payments and the release of the escrow funds to the Company. As a result, net loss for the fourth quarter of 2014 includes $25.7 million in one-time income in connection with the settlement with the former equityholders of Incline related to the representations and warranties included in the merger agreement.
[3] Net income for the fourth quarter of 2013 includes a $10.9 million increase related to the progression in development work for IONSYS related to the Company’s Incline acquisition and a tax benefit of $13.6 million from reducing the Company’s deferred tax liabilities associated with the Incline acquisition.
[4] Net loss for the first quarter of 2013 includes licensing costs of $25.0 million for a transaction with Alnylam on the PCSK9 RNAi hypercholesterolemia program.