Derivative Contracts (Details) (USD $) In Thousands, unless otherwise specified	Sep. 30, 2013		Jan. 30, 2013	Dec. 31, 2012
Derivatives, Fair Value [Line Items]
Convertible senior notes interest rate	3.00%
Notes [Member] | Notes Due February 1, 2033 [Member]
Derivatives, Fair Value [Line Items]
Convertible senior notes interest rate	3.00%		3.00%	3.00%
Not Designated as Hedging Instrument [Member] | Pharmsynthez Notes Receivable and Purchase Option [Member] | Prepaid expenses and other current assets [Member]
Derivatives, Fair Value [Line Items]
Derivative asset, fair value	$ 6,755			$ 0
Not Designated as Hedging Instrument [Member] | Neovasc common stock options/warrants [Member] | Investments, net [Member]
Derivatives, Fair Value [Line Items]
Derivative asset, fair value	1,618			1,872
Not Designated as Hedging Instrument [Member] | Embedded conversion option [Member] | 3.00% convertible, senior notes, net of discount and estimated fair value of embedded derivatives [Member]
Derivatives, Fair Value [Line Items]
Derivative liability, fair value	99,823			0
Not Designated as Hedging Instrument [Member] | Forward contracts [Member]
Derivatives, Fair Value [Line Items]
Derivative liability, fair value	3,899			1,294
Not Designated as Hedging Instrument [Member] | Forward contracts [Member] | Current portion of lines of credit and notes payable [Member]
Derivatives, Fair Value [Line Items]
Derivative liability, fair value	$ 3,899	[1]		$ 1,294	[1]

[1] The effect on loss in the forward contracts is recorded in Accrued expenses. The effect on income in the forward contracts is recorded in Prepaid expenses and other current assets.