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Consolidated Statements of Cash Flows - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Operating Activities      
Net income (loss) $ (760.5) $ (211.6) $ 219.5
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:      
Share-based compensation expense 23.1 45.1 42.4
Depreciation and amortization 125.1 143.3 123.8
Change in fair value of contingent obligations, net 0.2 2.6 2.9
Amortization of deferred financing costs 21.3 4.1 4.1
Deferred income taxes (8.9) (28.6) 46.0
Gain on sale of travel health business (74.2) 0.0 0.0
Goodwill impairment 218.2 6.7 41.7
Impairment of long-lived assets 306.7 0.0 0.0
Write off of contract asset and liability 0.0 0.0 (17.2)
Other 13.0 6.4 2.0
Changes in operating assets and liabilities:      
Accounts receivable (21.6) 118.1 (16.2)
Inventories 0.6 (57.1) (66.6)
Prepaid expenses and other assets 11.7 (19.9) 7.7
Accounts payable 10.6 (14.0) (1.6)
Accrued expenses and other liabilities (55.7) (66.7) (9.2)
Long-term incentive plan accrual 4.8 0.0 0.0
Accrued compensation (10.4) (0.8) 4.0
Income taxes receivable and payable, net (16.2) 28.7 (31.3)
Contract liabilities 5.9 9.6 (31.8)
Net cash provided by (used in) operating activities (206.3) (34.1) 320.2
Investing Activities      
Purchases of property, plant and equipment (51.6) (115.8) (224.1)
Royalty settlement payment 0.0 (21.8) 0.0
Milestone payment from prior asset acquisition (6.3) 0.0 0.0
Asset acquisitions 0.0 (243.7) 0.0
Proceeds from sale of travel health business, net 270.2 0.0 0.0
Net cash provided by (used in) investing activities 212.3 (381.3) (224.1)
Financing Activities      
Purchases of treasury stock 0.0 (82.1) (106.0)
Principal payments on convertible senior notes 0.0 0.0 (10.6)
Proceeds from revolving credit facility 20.0 598.0 0.0
Principal payments on revolving credit facility (398.8) 0.0 0.0
Principal payments on term loan facility (164.6) (33.8) (25.3)
Proceeds from stock-based compensation activity 1.8 5.0 15.9
Taxes paid for stock-based compensation activity (2.5) (5.9) (13.8)
Proceeds from at-the-market sale of stock, net of commissions and expenses 8.4 0.0 0.0
Contingent consideration payments 0.0 0.0 (1.2)
Net cash provided by (used in) financing activities: (535.7) 481.2 (141.0)
Effect of exchange rate changes on cash, cash equivalents and restricted cash (1.2) 0.5 (0.3)
Net change in cash, cash equivalents and restricted cash (530.9) 66.3 (45.2)
Cash, cash equivalents and restricted cash, beginning of period 642.6 576.3 621.5
Cash, cash equivalents and restricted cash, end of period 111.7 642.6 576.3
Supplemental cash flow disclosures:      
Cash paid for interest 68.3 33.0 30.4
Cash paid for income taxes 52.8 6.2 71.6
Non-cash investing and financing activities:      
Purchases of property, plant and equipment unpaid at period end 5.7 9.4 20.0
Purchases of treasury stock unpaid at period end 0.0 0.0 6.6
Gain on extinguishment of debt $ 2.5 $ 0.0 $ 0.0