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Business combinations - Schedule of PRA Health Sciences Inc Acquisition (Details) - USD ($) | Sep. 30, 2022 | Dec. 31, 2021 | Jul. 01, 2021 | Dec. 31, 2020
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Business Acquisition [Line Items] |  |  |  |
Goodwill | $ 8,942,525,000 | $ 9,037,931,000 |  | $ 936,257,000
PRA Health Sciences, Inc |  |  |  |
Business Acquisition [Line Items] |  |  |  |
Cash and cash equivalents |  |  | $ 259,971,000 |
Accounts receivable and unbilled revenue |  |  | 934,308,000 |
Other current assets |  |  | 125,156,000 |
Fixed assets |  |  | 156,851,000 |
Operating lease right-of-use assets |  |  | 180,601,000 |
Goodwill |  |  | 8,084,314,000 |
Intangible assets |  |  | 4,919,000,000 |
Deferred tax assets |  |  | 25,190,000 |
Other assets |  |  | 33,928,000 |
Accounts payable |  |  | (50,259,000) |
Accrued expenses and other current liabilities |  |  | (380,048,000) |
Current portion of operating lease liabilities |  |  | (36,506,000) |
Unearned revenue |  |  | (739,278,000) |
Non-current portion of operating lease liabilities |  |  | (147,204,000) |
Non-current deferred tax liabilities |  |  | (1,119,762,000) |
Other non-current liabilities |  |  | (204,291,000) |
Net assets acquired |  |  | 12,041,971,000 |
Goodwill expected to be tax deductible |  |  | $ 0 |

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