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Intangible assets
 3 Months Ended
Mar. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]  
Intangible assets Intangible assets
The carrying amount of Intangible Assets for the periods ended March 31, 2024 and December 31, 2023 is as follows:

March 31, 2024December 31, 2023
(in thousands)
Cost
Customer relationships$4,089,517 $4,090,393 
Order backlog540,921 541,302 
Trade names & brands204,629 204,653 
Patient database170,345 170,366 
Technology assets151,000 141,257 
Total cost5,156,412 5,147,971 
Accumulated amortization(1,407,473)(1,292,106)
 Net book value$3,748,939 $3,855,865 
In the three months ended March 31, 2024, the amortization expense recognized by the Company was $116.5 million (year ended December 31, 2023: $459.9 million).
On January 9, 2024, the Company acquired HumanFirst. The acquisition resulted in the recognition of a developed technology intangible asset of $9.9 million. Refer to note 5. Goodwill for further details.
The identifiable intangible assets are amortized over their estimated useful lives.