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Intangible assets (Tables)
6 Months Ended
Jun. 30, 2023
Goodwill and Intangible Assets Disclosure [Abstract]  
Schedule of Finite-Lived Intangible Assets
Intangible assets are amortized on a straight-line basis over the expected useful life, as set forth in the table below:

Estimated Useful Life
Customer relationships23 years
Order backlog3 years
Trade names3 years
Patient database7 years
Technology assets5 years
Intangible assets, net consisted of the following:
Six Months EndedYear Ended
June 30, 2023December 31, 2022
Cost(in thousands)
Customer relationships$4,077,225 $4,076,435 
Order backlog537,182 536,934 
Trade names & brands204,636 204,621 
Patient database170,342 170,238 
Technology assets121,110 120,984 
Total cost5,110,495 5,109,212 
Accumulated amortization(1,060,702)(830,553)
 Net book value$4,049,793 $4,278,659