Investments - Narrative (Details) - USD ($) $ in Thousands		1 Months Ended	3 Months Ended								12 Months Ended
	Sep. 14, 2021	Aug. 31, 2020	Dec. 31, 2021	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021	Dec. 31, 2020	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Business Acquisition [Line Items]
Total assets of equity method investees			$ 2,399,715				$ 2,473,063				$ 2,399,715	$ 2,473,063
Total liabilities of equity method investees			714,589				801,512				714,589	801,512
Market value of equity method investees			4,500				7,500				4,500	7,500
Total revenues			401,332	$ 385,813	$ 442,408	$ 545,165	494,676	$ 428,064	$ 301,207	$ 211,466	1,774,718	1,435,413	$ 901,935
Revenue from transfer of intellectual property and other
Business Acquisition [Line Items]
Total revenues											25,842	53,219	$ 73,317
Corporate Joint Venture | LeaderMed | LenderMed Joint Venture
Business Acquisition [Line Items]
Joint venture (in shares)	4,703
Ownership interest in joint venture (as a percent)	47.00%
Corporate Joint Venture | LeaderMed | LenderMed Joint Venture | Revenue from transfer of intellectual property and other
Business Acquisition [Line Items]
Total revenues	$ 1,000										1,000
Equity Method Investment, Nonconsolidated Investee or Group of Investees
Business Acquisition [Line Items]
Total assets of equity method investees			223,600				90,900				223,600	90,900
Total liabilities of equity method investees			$ 37,900				$ 28,400				37,900	28,400
Net losses of equity method investees											$ 69,400	$ 75,400
Pharmsynthez
Business Acquisition [Line Items]
Equity method investments (as a percent)			9.00%								9.00%
Cocrystal Pharma
Business Acquisition [Line Items]
Equity method investments (as a percent)			3.00%								3.00%
NIMS
Business Acquisition [Line Items]
Equity method investments (as a percent)			1.00%								1.00%
Neovasc
Business Acquisition [Line Items]
Equity method investments (as a percent)			1.00%								1.00%
InCellDx, Inc
Business Acquisition [Line Items]
Equity method investments (as a percent)			29.00%								29.00%
BioCardia, Inc.
Business Acquisition [Line Items]
Equity method investments (as a percent)			1.00%								1.00%
Warrants to purchase common shares (in shares)			47,000								47,000
Xenetic Biosciences, Inc.
Business Acquisition [Line Items]
Equity method investments (as a percent)			1.00%								1.00%
Phio Pharmaceuticals
Business Acquisition [Line Items]
Equity security investments (as a percent)			0.01%								0.01%
VBI Vaccines Inc
Business Acquisition [Line Items]
Equity security investments (as a percent)			1.00%								1.00%
ChromaDex Corporation
Business Acquisition [Line Items]
Equity security investments (as a percent)			0.10%								0.10%
Eloxx Pharmaceuticals
Business Acquisition [Line Items]
Equity security investments (as a percent)			2.00%								2.00%
CAMP4
Business Acquisition [Line Items]
Equity security investments (as a percent)			4.58%								4.58%
HealthSnap
Business Acquisition [Line Items]
Equity security investments (as a percent)			6.46%								6.46%
Cocrystal
Business Acquisition [Line Items]
Warrants to purchase common shares (in shares)			33,000								33,000
InCellDx Inc.
Business Acquisition [Line Items]
Warrants to purchase common shares (in shares)			700,000								700,000
Detect Genomix | Variable Interest Entity, Not Primary Beneficiary
Business Acquisition [Line Items]
Equity method investments (as a percent)		49.00%
Payments in equity method investment		$ 245
Zebra | Variable Interest Entity, Not Primary Beneficiary
Business Acquisition [Line Items]
Equity method investments (as a percent)			29.00%				29.00%				29.00%	29.00%
Zebra | Series A Preferred Stock
Business Acquisition [Line Items]
Investment owned, shares (in shares)			1,260,000								1,260,000
Zebra | Restricted Stock
Business Acquisition [Line Items]
Investment owned, shares (in shares)			900,000								900,000