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Selected Quarterly Financial Data Selected Quarterly Financial Data (Details) (USD $)
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
Dec. 31, 2013
Dec. 31, 2012
Feb. 28, 2013
Quarterly Financial Information Disclosure [Abstract]                        
Net revenue $ 190,998,000us-gaap_SalesRevenueNet [1],[2] $ 172,401,000us-gaap_SalesRevenueNet $ 183,774,000us-gaap_SalesRevenueNet [1] $ 177,235,000us-gaap_SalesRevenueNet $ 185,003,000us-gaap_SalesRevenueNet [3] $ 174,282,000us-gaap_SalesRevenueNet $ 172,826,000us-gaap_SalesRevenueNet $ 155,753,000us-gaap_SalesRevenueNet [4] $ 724,408,000us-gaap_SalesRevenueNet $ 687,864,000us-gaap_SalesRevenueNet $ 558,588,000us-gaap_SalesRevenueNet  
Cost of revenue 66,000,000us-gaap_CostOfGoodsAndServicesSold [1],[2] 69,076,000us-gaap_CostOfGoodsAndServicesSold 85,687,000us-gaap_CostOfGoodsAndServicesSold [1] 66,867,000us-gaap_CostOfGoodsAndServicesSold 76,339,000us-gaap_CostOfGoodsAndServicesSold [3] 65,794,000us-gaap_CostOfGoodsAndServicesSold 63,938,000us-gaap_CostOfGoodsAndServicesSold 56,714,000us-gaap_CostOfGoodsAndServicesSold [4] 287,630,000us-gaap_CostOfGoodsAndServicesSold 262,785,000us-gaap_CostOfGoodsAndServicesSold 177,339,000us-gaap_CostOfGoodsAndServicesSold  
Total operating expenses 225,779,000us-gaap_CostsAndExpenses [1],[2] 185,052,000us-gaap_CostsAndExpenses 215,660,000us-gaap_CostsAndExpenses [1] 162,484,000us-gaap_CostsAndExpenses 200,865,000us-gaap_CostsAndExpenses [3] 151,509,000us-gaap_CostsAndExpenses 143,907,000us-gaap_CostsAndExpenses 178,392,000us-gaap_CostsAndExpenses [4] 788,975,000us-gaap_CostsAndExpenses 674,673,000us-gaap_CostsAndExpenses 475,515,000us-gaap_CostsAndExpenses  
Net (loss) income (5,323,000)us-gaap_NetIncomeLoss [1],[2] (16,736,000)us-gaap_NetIncomeLoss (5,157,000)us-gaap_NetIncomeLoss [1] (4,996,000)us-gaap_NetIncomeLoss 1,198,000us-gaap_NetIncomeLoss [3] 7,793,000us-gaap_NetIncomeLoss 18,094,000us-gaap_NetIncomeLoss (11,573,000)us-gaap_NetIncomeLoss [4] (32,348,000)us-gaap_NetIncomeLoss 15,260,000us-gaap_NetIncomeLoss 51,170,000us-gaap_NetIncomeLoss  
Basic (USD per share) $ (0.08)us-gaap_EarningsPerShareBasic [1],[2] $ (0.26)us-gaap_EarningsPerShareBasic $ (0.08)us-gaap_EarningsPerShareBasic [1] $ (0.08)us-gaap_EarningsPerShareBasic $ 0.02us-gaap_EarningsPerShareBasic [3] $ 0.13us-gaap_EarningsPerShareBasic $ 0.33us-gaap_EarningsPerShareBasic $ (0.21)us-gaap_EarningsPerShareBasic [4] $ (0.50)us-gaap_EarningsPerShareBasic $ 0.27us-gaap_EarningsPerShareBasic $ 0.96us-gaap_EarningsPerShareBasic  
Diluted (USD per share) $ (0.08)us-gaap_EarningsPerShareDiluted [1],[2] $ (0.26)us-gaap_EarningsPerShareDiluted $ (0.08)us-gaap_EarningsPerShareDiluted [1] $ (0.08)us-gaap_EarningsPerShareDiluted $ 0.02us-gaap_EarningsPerShareDiluted [3] $ 0.12us-gaap_EarningsPerShareDiluted $ 0.30us-gaap_EarningsPerShareDiluted $ (0.21)us-gaap_EarningsPerShareDiluted [4] $ (0.50)us-gaap_EarningsPerShareDiluted $ 0.25us-gaap_EarningsPerShareDiluted $ 0.93us-gaap_EarningsPerShareDiluted  
Business Acquisition [Line Items]                        
Settlement                 25,736,000us-gaap_GainLossRelatedToLitigationSettlement 0us-gaap_GainLossRelatedToLitigationSettlement 0us-gaap_GainLossRelatedToLitigationSettlement  
Impairment charges 6,400,000us-gaap_AssetImpairmentCharges   15,100,000us-gaap_AssetImpairmentCharges                  
Incline Therapeutics, Inc. [Member]                        
Business Acquisition [Line Items]                        
Increase in contingent consideration         10,900,000us-gaap_BusinessCombinationContingentConsiderationArrangementsChangeInAmountOfContingentConsiderationLiability1
/ us-gaap_BusinessAcquisitionAxis
= mdco_InclineTherapeuticsIncMember
             
Decrease in deferred lax liability         13,600,000mdco_IncreaseDecreaseDeferredTaxLiabilities
/ us-gaap_BusinessAcquisitionAxis
= mdco_InclineTherapeuticsIncMember
             
Settlement 25,700,000us-gaap_GainLossRelatedToLitigationSettlement
/ us-gaap_BusinessAcquisitionAxis
= mdco_InclineTherapeuticsIncMember
                     
Alnylam Pharmaceuticals, Inc. [Member]                        
Business Acquisition [Line Items]                        
Initial payment               $ 25,000,000mdco_CollaborativeArrangementCashPayment
/ us-gaap_TypeOfArrangementAxis
= mdco_AlnylamPharmaceuticalsInc.Member
      $ 25,000,000mdco_CollaborativeArrangementCashPayment
/ us-gaap_TypeOfArrangementAxis
= mdco_AlnylamPharmaceuticalsInc.Member
[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.