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Intangible assets | 9 Months Ended
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Sep. 30, 2022
Goodwill and Intangible Assets Disclosure [Abstract] |
Intangible assets | Intangible assets Intangible assets, net consisted of the following:
| Nine Months Ended | Year Ended
| September 30, 2022 | December 31, 2021
Cost | (in thousands)
Customer relationships | $ | 4,072,988 |  | $ | 4,056,642 |
Order backlog | 535,557 |  | 528,022 |
Trade names & brands | 204,536 |  | 204,685 |
Patient database | 170,049 |  | 170,525 |
Technology assets | 120,283 |  | 121,507 |
Total cost | 5,103,413 |  | 5,081,381 |
Accumulated amortization | (711,714) |  | (370,538) |
Net book value | $ | 4,391,699 |  | $ | 4,710,843 |
The identifiable intangible assets are amortized over their estimated useful lives.

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- Definition The entire disclosure for all or part of the information related to intangible assets. + References Reference 1: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -SubTopic 30 -URI https://asc.fasb.org/subtopic&trid=2144471 + Details
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