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Intangible assets (Details) - USD ($) $ in Thousands | Mar. 31, 2023 | Dec. 31, 2022
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Finite-Lived Intangible Assets [Line Items] |  |
Total cost | $ 5,110,593 | $ 5,109,212
Accumulated amortization | (946,183) | (830,553)
Net book value | 4,164,410 | 4,278,659
Customer relationships |  |
Finite-Lived Intangible Assets [Line Items] |  |
Total cost | 4,077,267 | 4,076,435
Order backlog |  |
Finite-Lived Intangible Assets [Line Items] |  |
Total cost | 537,247 | 536,934
Trade names & brands |  |
Finite-Lived Intangible Assets [Line Items] |  |
Total cost | 204,640 | 204,621
Patient database |  |
Finite-Lived Intangible Assets [Line Items] |  |
Total cost | 170,298 | 170,238
Technology assets |  |
Finite-Lived Intangible Assets [Line Items] |  |
Total cost | $ 121,141 | $ 120,984

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