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Intangible assets (Details) - USD ($)
$ in Thousands
Jun. 30, 2023
Dec. 31, 2022
Finite-Lived Intangible Assets [Line Items]    
Total cost $ 5,110,495 $ 5,109,212
Accumulated amortization (1,060,702) (830,553)
 Net book value 4,049,793 4,278,659
Customer relationships    
Finite-Lived Intangible Assets [Line Items]    
Total cost 4,077,225 4,076,435
Order backlog    
Finite-Lived Intangible Assets [Line Items]    
Total cost 537,182 536,934
Trade names & brands    
Finite-Lived Intangible Assets [Line Items]    
Total cost 204,636 204,621
Patient database    
Finite-Lived Intangible Assets [Line Items]    
Total cost 170,342 170,238
Technology assets    
Finite-Lived Intangible Assets [Line Items]    
Total cost $ 121,110 $ 120,984