Composition of Certain Financial Statement Captions (Details) - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
Accounts receivable, net:
Accounts receivable	$ 159,119	$ 166,962
Less: allowance for doubtful accounts	(1,745)	(1,446)
Accounts receivable, net	157,374	165,516
Inventories, net:
Consumable supplies	22,728	21,546
Finished products	14,925	21,012
Work in-process	3,018	5,873
Raw materials	5,106	7,467
Less: inventory reserve	(2,398)	(6,565)
Inventory, net	43,379	49,333
Other current assets and prepaid expenses:
Taxes recoverable	20,259	18,138
Other receivables	4,014	8,798
Prepaid supplies	12,135	8,207
Prepaid insurance	4,695	3,532
Other	4,243	3,838
Other current assets and prepaid expenses	45,346	42,513
Intangible assets, net:
Less: accumulated amortization	(248,641)	(198,935)
Intangible assets, net	631,434	683,835
Accrued expenses:
Contract liabilities	61,734	61,388
Employee benefits	39,953	50,377
Clinical trials	12,582	12,191
Taxes payable	4,520	4,609
Contingent consideration	2,092	11,750
Capital leases short-term	3,488	3,399
Milestone payment	9,822	4,868
Professional fees	3,705	2,355
Other	77,011	79,364
Accrued expenses	214,907	230,301
Other long-term liabilities:
Contract liabilities	28,113	78,990
Line of credit	104,025	104,152
Contingent consideration	26,856	29,603
Mortgages and other debts payable	1,142	1,567
Capital leases long-term	6,188	7,786
Other	17,488	17,857
Other long-term liabilities	183,812	239,955
Customer relationships
Intangible assets, net:
Intangible assets	446,962	448,345
Technologies
Intangible assets, net:
Intangible assets	340,786	340,921
Trade names
Intangible assets, net:
Intangible assets	50,490	50,553
Licenses
Intangible assets, net:
Intangible assets	10,231	10,305
Covenants not to compete
Intangible assets, net:
Intangible assets	16,369	16,372
Product registrations
Intangible assets, net:
Intangible assets	9,569	10,475
Other
Intangible assets, net:
Intangible assets	$ 5,668	$ 5,799