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Intangible assets | 9 Months Ended
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Sep. 30, 2023
Goodwill and Intangible Assets Disclosure [Abstract] |
Intangible assets | Intangible assets Intangible assets, net consisted of the following:
| Nine Months Ended | Year Ended
| September 30, 2023 | December 31, 2022
Cost | (in thousands)
Customer relationships | $ | 4,076,010 |  | $ | 4,076,435 |
Order backlog | 536,716 |  | 536,934 |
Trade names & brands | 204,608 |  | 204,621 |
Patient database | 170,262 |  | 170,238 |
Technology assets | 120,875 |  | 120,984 |
Total cost | 5,108,471 |  | 5,109,212 |
Accumulated amortization | (1,173,798) |  | (830,553) |
Net book value | $ | 3,934,673 |  | $ | 4,278,659 |
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 -Topic 350 -SubTopic 30 -Name Accounting Standards Codification -Publisher FASB -URI https://asc.fasb.org//350-30/tableOfContent + Details
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