Revenue Recognition - Narrative (Details) - USD ($) $ in Thousands			3 Months Ended								12 Months Ended
	Jul. 06, 2021	May 05, 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
Disaggregation of Revenue [Line Items]
Prior period performance obligation revenue recognized											$ 40,400	$ 300	$ 24,800
Overpayment reimbursement liability			$ 5,000				$ 14,900				5,000	14,900
Revenue recognized											15,911
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
Rayaldee
Disaggregation of Revenue [Line Items]
Revenue recognized											27,000	36,800	31,400
Total revenues											64,301	88,187	73,965
Transfer of intellectual property and other
Disaggregation of Revenue [Line Items]
Total revenues											25,842	53,219	73,317
Transfer of intellectual property and other | Products
Disaggregation of Revenue [Line Items]
Total revenues		$ 3,000										3,000
Pfizer | Transfer of intellectual property and other | Products
Disaggregation of Revenue [Line Items]
Total revenues											10,800	28,700	$ 66,800
LeaderMed | Transfer of intellectual property and other | Products
Disaggregation of Revenue [Line Items]
Total revenues											1,000
CAMP4 | Transfer of intellectual property and other
Disaggregation of Revenue [Line Items]
Total revenues	$ 1,500
CAMP4 | Transfer of intellectual property and other | Products
Disaggregation of Revenue [Line Items]
Total revenues				$ 4,900							4,900
Nicoya | Transfer of intellectual property and other | Products
Disaggregation of Revenue [Line Items]
Total revenues											$ 5,000
BioReference Laboratories, Inc. | Transfer of intellectual property and other | Products
Disaggregation of Revenue [Line Items]
Total revenues												$ 16,200