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Indirect Cash Flow (Details) - USD ($)
$ in Thousands
 6 Months Ended 12 Months Ended
Dec. 31, 2020
Jun. 17, 2020
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Supplemental Cash Flow Elements [Abstract]          
Net income $ 1,077,069 $ 624,885 $ 230,064 $ 1,241,201 $ 1,701,954
Adjustments to reconcile consolidated net income to net cash provided by operating activities:          
Income from financial royalty assets     (2,125,096) (2,065,083) (1,959,975)
Provision for changes in expected cash flows from financial royalty assets     904,244 452,842 230,839
Amortization of intangible assets     5,670 22,996 23,058
Amortization of debt discount and issuance costs     21,356 20,162 11,715
(Gains)/losses on derivative financial instruments     (96,610) 21,532 42,076
Losses/(gains) on equity securities     33,442 48,066 (247,073)
Equity in losses/(earnings) of equity method investees     8,973 19,490 (44,459)
Distributions from equity method investees     39,142 34,384 42,334
Loss on extinguishment of debt     419 358 30,272
Share-based compensation     2,170 2,443 5,428
Interest income accretion     (53,432) (50,896) (20,551)
Losses/(gains) on available for sale debt securities     6,815 (17,859) (18,600)
Financial royalty asset impairment     615,827 0 65,053
Termination of derivative financial instruments     0 (16,093) (34,952)
Other     11,098 4,461 9,621
Decrease/(increase) in operating assets:          
Cash collected on financial royalty assets     2,507,236 2,315,854 2,121,923
Accrued royalty receivable     36,456 (20,131) 370
Other royalty income receivable     (4,744) (9,012) (770)
Other current assets     2,198 1,857 34,986
Increase/(decrease) in operating liabilities:          
Accounts payable and accrued expenses     2,286 (4,586) (766)
Interest payable     (3,534) 15,550 42,146
Net cash provided by operating activities     2,143,980 2,017,536 2,034,629
Supplemental Schedule of Non-cash Investing/Financing Activities:          
Receipt of contribution of investments in Legacy Investors Partnerships     0 0 303,679
Settlement of Epizyme forward purchase contract (Note 4)     0 0 5,700
Accrued purchase obligation - Tazverik     0 0 110,000
Repayments of long-term debt by contributions from non-controlling interest     0 0 1,103,774
Milestone payable - Erleada     $ 12,400 $ 0 $ 18,600