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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (unaudited) - USD ($)
$ in Thousands
 9 Months Ended
Sep. 30, 2023
Sep. 30, 2022
CASH FLOWS FROM OPERATING ACTIVITIES:    
Net income (loss) $ 242,978 $ (130,013)
Adjustments to reconcile net income (loss) to cash flows from operating activities:    
Depreciation and amortization 56,386 58,185
Share-based compensation expense 75,062 67,771
Deferred income taxes (47,385) (54,073)
Change in the fair value of contingent consideration   21,750
Other non-cash charges 1,394 3,746
Changes in assets and liabilities:    
Receivables (49,730) 56,045
Contract assets 6,163 3,258
Inventory (9,866) (15,646)
Prepaid expenses and other assets 3,947 1,872
Right-of-use assets 12,685 12,470
Accounts payable and accrued expenses 20,958 6,386
Accrued sales discounts, allowances and reserves (13,649) (1,576)
Contract liabilities (5,724) (9,191)
Operating lease liabilities (12,569) (13,411)
Other long-term liabilities 13,466 12,424
Cash flows provided by operating activities 294,116 19,997
CASH FLOWS FROM INVESTING ACTIVITIES:    
Additions of property, plant and equipment (31,018) (28,227)
Proceeds from the sale of equipment 6  
Proceeds from contingent consideration   1,273
Return of Fountain Healthcare Partners II, L.P. investment   485
Purchases of investments (186,593) (256,806)
Sales and maturities of investments 291,944 190,994
Cash flows provided by (used in) investing activities 74,339 (92,281)
CASH FLOWS FROM FINANCING ACTIVITIES:    
Proceeds from the issuance of ordinary shares under share-based compensation arrangements 15,113 18,850
Employee taxes paid related to net share settlement of equity awards (26,080) (17,903)
Principal payments of long-term debt (2,250) (2,250)
Cash flows used in financing activities (13,217) (1,303)
NET INCREASE (DECREASE) IN CASH AND CASH EQUIVALENTS 355,238 (73,587)
CASH AND CASH EQUIVALENTS—Beginning of period 292,473 337,544
CASH AND CASH EQUIVALENTS—End of period 647,711 263,957
Non-cash investing and financing activities:    
Purchased capital expenditures included in accounts payable and accrued expenses $ 4,209 $ 2,690