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Income Taxes - Reconciliation of Tax Rate (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Effective Income Tax Rate Reconciliation, Amount [Abstract]
Income tax (benefit) provision - at statutory tax rate	$ (20,097)	$ (13,916)	$ (11,642)
Differences in international tax rates	(6,341)	(9,921)	(8,950)
Change in valuation allowances	24,332	48,734	4,296
Nondeductible share-based compensation	798	1,424	645
Unrealized tax benefits	160	258	239
State and local taxes (net of federal)	(5,614)	(4,467)	60
Nondeductible interest expense	4,362	4,239	2,173
Orphan drug and R&D tax credit	899	0	(1,524)
Other	1,000	(326)	(1,113)
Income tax (benefit) provision	$ (501)	$ 26,025	$ (15,816)

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Effective Income Tax Rate Reconciliation, Amount, Orphan Drug and Research And Development Tax Credit

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Amount of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations.

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Amount of the difference between reported income tax expense (benefit) and expected income tax expense (benefit) computed by applying the domestic federal statutory income tax rates to pretax income (loss) from continuing operations attributable to increase (decrease) in the valuation allowance for deferred tax assets.

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Amount of the difference between reported income tax expense (benefit) and expected income tax expense (benefit) computed by applying the domestic federal statutory income tax rates to pretax income (loss) from continuing operations attributable to foreign income tax expense (benefit).

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Amount of the difference between reported income tax expense (benefit) and expected income tax expense (benefit) computed by applying the domestic federal statutory income tax rates to pretax income (loss) from continuing operations attributable to tax exempt income, equity in earnings (loss) of an unconsolidated subsidiary, minority noncontrolling interest income (loss), tax holiday, disposition of a business, disposition of an asset, repatriation of foreign earnings, repatriation of foreign earnings jobs creation act of 2004, increase (decrease) in enacted tax rate, prior year income taxes, increase (decrease) in deferred tax asset valuation allowance, and other adjustments.

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