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Accrued and Other Current Liabilities (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Accrued and Other Current Liabilities
Royalties	$ 410,312	$ 387,362
Clinical related costs	94,554	109,618
Sales allowances	358,541	279,914
Sales and marketing	41,971	37,369
Accrued Taxes	126,762	42,295
Operating lease liabilities	4,783	5,686
Other current liabilities	65,345	73,325
Total accrued and other current liabilities	$ 1,102,268	$ 935,569	[1]
[1] The condensed consolidated balance sheet at December 31, 2023 has been derived from the audited consolidated financial statements at that date.

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Carrying value as of the balance sheet date of obligations incurred through that date and payable for clinical related costs. Used to reflect the current portion of the liabilities (due within one year or within the normal operating cycle if longer).

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Carrying amount as of the balance sheet date of the unpaid sum of the known and estimated amounts payable to satisfy all currently due domestic and foreign income tax obligations.

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Carrying value as of the balance sheet date of obligations incurred and payable, pertaining to costs that are statutory in nature, are incurred on contractual obligations, or accumulate over time and for which invoices have not yet been received or will not be rendered. Examples include taxes, interest, rent and utilities. Used to reflect the current portion of the liabilities (due within one year or within the normal operating cycle if longer).

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Carrying value as of the balance sheet date of obligations incurred through that date and payable for the marketing, trade and selling of the entity's goods and services. Marketing costs would include expenditures for planning and executing the conception, pricing, promotion, and distribution of ideas, goods, and services; costs of public relations and corporate promotions; and obligations incurred and payable for sales discounts, rebates, price protection programs, etc. offered to customers and under government programs. Used to reflect the current portion of the liabilities (due within one year or within the normal operating cycle if longer).

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Carrying value as of the balance sheet date of obligations incurred through that date and payable for royalties. Used to reflect the current portion of the liabilities (due within one year or within the normal operating cycle if longer).

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Cumulative provision for contract losses not offset against related costs accumulated on the balance sheet.

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