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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
OPERATING ACTIVITIES:      
Net income $ 133,892 $ 50,201 $ 60,801
Adjustments to reconcile net income to net cash provided by operating activities:      
Depreciation and amortization 116,031 109,462 110,730
Non-cash in-process research and development expense 519 64,916 0
Non-cash impairment charges 0 5,764 4,941
Income tax expense (benefit) (64,138) (19,046) (8,184)
Share-based compensation 19,590 21,255 20,779
Amortization of debt issuance costs and expenses associated with debt refinancing 12,076 5,390 6,270
Non-cash lease expense 2,955 5,060 0
Accretion of bond issuance discount 15,415 0 0
Loss on disposal of property and equipment and construction in-progress 7,855 1,821 1,385
Change in fair value of contingent consideration and others 951 1,119 1,214
Changes in assets and liabilities:      
Accounts receivable 52,105 (9,428) (17,021)
Inventories (48,348) (43,308) 8,300
Prepaid expenses and other current assets 1,632 13,071 3,933
Other non-current assets 13,735 13,156 1,052
Accounts payable, accrued expenses and other current liabilities (57,512) 14,666 3,588
Contract liabilities (37) (607) 1,504
Other non-current liabilities (2,889) (2,059) 391
Net cash provided by operating activities 203,832 231,433 199,683
INVESTING ACTIVITIES:      
Purchases of property and equipment (38,890) (69,537) (77,741)
Acquired in-process research and development and intangibles (25,000) (64,995) 0
Proceeds from note receivable 0 752 910
Cash used in business acquisitions, net of cash acquired 0 (30,509) 26,704
Proceeds from sales of property and equipment 3,657 37 422
Net proceeds(payments) on swaps designated as net investment hedges (7,840) 1,584 0
Net cash used in investing activities (68,073) (162,668) (49,705)
FINANCING ACTIVITIES:      
Proceeds from borrowings of long-term indebtedness 171,500 236,900 171,200
Payments on debt (441,000) (246,100) (660,000)
Purchase of option hedge on convertible notes (104,248) 0 0
Proceeds from convertible notes issuance 575,000 0 0
Proceeds from sale of stock purchase warrants 44,563 0 0
Payment of debt issuance costs (24,347) 0 (5,037)
Purchase of treasury stock (100,000) 0 0
Proceeds from exercised stock options 5,232 6,948 9,392
Net cash paid for contingent consideration 0 0 (38,196)
Proceeds from the issuance of common stock, net of issuance costs 0 0 349,590
Cash taxes paid in net equity settlement (5,075) (6,514) (7,821)
Net cash provided by (used in) financing activities 121,625 (8,766) (180,872)
Effect of exchange rate changes on cash and cash equivalents 13,871 74 (5,203)
Net increase (decrease) in cash and cash equivalents 271,255 60,073 (36,097)
Cash and cash equivalents at beginning of period 198,911 138,838 174,935
Cash and cash equivalents at end of period $ 470,166 $ 198,911 $ 138,838