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Intangible assets (Details) - USD ($) $ in Thousands | Mar. 31, 2024 | Dec. 31, 2023
--- | --- | ---
Cost |  |
Total cost | $ 5,156,412 | $ 5,147,971
Accumulated amortization | (1,407,473) | (1,292,106)
Net book value | 3,748,939 | 3,855,865
Customer relationships |  |
Cost |  |
Total cost | 4,089,517 | 4,090,393
Order backlog |  |
Cost |  |
Total cost | 540,921 | 541,302
Trade names & brands |  |
Cost |  |
Total cost | 204,629 | 204,653
Patient database |  |
Cost |  |
Total cost | 170,345 | 170,366
Technology assets |  |
Cost |  |
Total cost | $ 151,000 | $ 141,257

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