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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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- Definition

Accumulated amount of amortization of assets, excluding financial assets and goodwill, lacking physical substance with a finite life.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 210
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
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-Publisher FASB
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-Topic 350
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Amount before amortization of assets, excluding financial assets and goodwill, lacking physical substance with a finite life.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 928
-SubTopic 340
-Name Accounting Standards Codification
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Amount after amortization of assets, excluding financial assets and goodwill, lacking physical substance with a finite life.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 926
-SubTopic 20
-Name Accounting Standards Codification
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