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Net Revenues - Discounts and Other Reductions (Details) - EUR (€) € in Thousands | 12 Months Ended
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Dec. 31, 2019 | Dec. 31, 2018 | Dec. 31, 2017
Discounts and other reductions in gross income |  |  |
Gross sales | € 6,429,762 | € 5,588,257 | € 5,322,618
Chargebacks | (1,119,540) | (923,023) | (826,775)
Cash discounts | (70,340) | (62,518) | (57,512)
Volume rebates | (56,426) | (46,922) | (43,274)
Medicare and Medicaid | (50,442) | (40,343) | (41,722)
Other discounts | (34,323) | (28,727) | (35,262)
Total net sales | € 5,098,691 | € 4,486,724 | € 4,318,073

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