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Intangible assets - Schedule of Finite-Lived Intangible Assets (Details) - USD ($)
$ in Thousands
Jun. 30, 2024
Dec. 31, 2023
Cost    
Total cost $ 5,155,958 $ 5,147,971
Accumulated amortization (1,523,604) (1,292,106)
 Net book value 3,632,354 3,855,865
Customer relationships    
Cost    
Total cost 4,089,261 4,090,393
Order backlog    
Cost    
Total cost 540,795 541,302
Trade names & brands    
Cost    
Total cost 204,621 204,653
Patient database    
Cost    
Total cost 170,348 170,366
Technology assets    
Cost    
Total cost $ 150,933 $ 141,257