Composition of Certain Financial Statement Captions (Details) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
Accounts receivable, net:
Accounts receivable	$ 160,169	$ 166,962
Less: allowance for doubtful accounts	(1,527)	(1,446)
Accounts receivable, net	158,642	165,516
Inventories, net:
Consumable supplies	22,138	21,546
Finished products	22,137	21,012
Work in-process	4,505	5,873
Raw materials	6,892	7,467
Less: inventory reserve	(5,857)	(6,565)
Inventory, net	49,815	49,333
Other current assets and prepaid expenses:
Taxes recoverable	17,359	18,138
Other receivables	7,980	8,798
Prepaid supplies	9,058	8,207
Prepaid insurance	2,179	3,532
Other	4,370	3,838
Other current assets and prepaid expenses	40,946	42,513
Intangible assets, net:
Less: accumulated amortization	(216,656)	(198,935)
Intangible assets, net	667,637	683,835
Accrued expenses:
Contract liabilities	61,378	61,388
Employee benefits	46,708	50,377
Clinical trials	14,130	12,191
Taxes payable	2,592	4,609
Contingent consideration	5,254	11,750
Capital leases short-term	3,366	3,399
Milestone payment	4,918	4,868
Professional fees	2,856	2,355
Other	75,931	79,364
Accrued expenses	217,133	230,301
Other long-term liabilities:
Contract liabilities	63,642	78,990
Line of credit	105,091	104,152
Contingent consideration	37,858	29,603
Mortgages and other debts payable	1,432	1,567
Capital leases long-term	7,342	7,786
Other	18,257	17,857
Other long-term liabilities	233,622	239,955
Customer relationships
Intangible assets, net:
Intangible assets	449,474	448,345
Technologies
Intangible assets, net:
Intangible assets	341,044	340,921
Trade names
Intangible assets, net:
Intangible assets	50,582	50,553
Licenses
Intangible assets, net:
Intangible assets	10,306	10,305
Covenants not to compete
Intangible assets, net:
Intangible assets	16,381	16,372
Product registrations
Intangible assets, net:
Intangible assets	10,586	10,475
Other
Intangible assets, net:
Intangible assets	$ 5,920	$ 5,799