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Accrued and Other Current Liabilities (Details) - USD ($)
$ in Thousands
Jun. 30, 2024
Dec. 31, 2023
Accrued and Other Current Liabilities    
Royalties $ 444,305 $ 387,362
Clinical related costs 105,675 109,618
Sales allowances 349,904 279,914
Sales and marketing 39,541 37,369
Accrued Taxes 32,396 42,295
Operating lease liabilities 4,929 5,686
Other current liabilities 57,566 73,325
Total accrued and other current liabilities $ 1,034,316 $ 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.