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Intangible assets (Details) - USD ($) $ in Thousands | Mar. 31, 2022 | Dec. 31, 2021
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Finite-Lived Intangible Assets [Line Items] |  |
Total cost | $ 5,079,026 | $ 5,081,381
Accumulated amortization | (486,439) | (370,538)
Net book value | 4,592,587 | 4,710,843
Customer relationships |  |
Finite-Lived Intangible Assets [Line Items] |  |
Total cost | 4,055,260 | 4,056,642
Order backlog |  |
Finite-Lived Intangible Assets [Line Items] |  |
Total cost | 527,451 | 528,022
Trade names & brands |  |
Finite-Lived Intangible Assets [Line Items] |  |
Total cost | 204,648 | 204,685
Patient database |  |
Finite-Lived Intangible Assets [Line Items] |  |
Total cost | 170,456 | 170,525
Technology assets |  |
Finite-Lived Intangible Assets [Line Items] |  |
Total cost | $ 121,211 | $ 121,507

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