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Intangible assets | 9 Months Ended
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Sep. 30, 2024
Goodwill and Intangible Assets Disclosure [Abstract] |
Intangible assets | Intangible assets The carrying amount of Intangible Assets as of September 30, 2024 and December 31, 2023 is as follows:
| September 30, 2024 | December 31, 2023
| (in thousands)
Cost |  |
Customer relationships | $ | 4,119,115 |  | $ | 4,090,393 |
Order backlog | 544,546 |  | 541,302 |
Trade names & brands | 204,666 |  | 204,653 |
Patient database | 170,501 |  | 170,366 |
Technology assets | 151,306 |  | 141,257 |
Total cost | 5,190,134 |  | 5,147,971 |
Accumulated amortization | (1,584,320) |  | (1,292,106) |
Net book value | $ | 3,605,814 |  | $ | 3,855,865 |
In the nine months ended September 30, 2024, the amortization expense recognized by the Company was $291.0 million (nine months ended September 30, 2023: $343.9 million and ye ar ended December 31, 2023: $459.9 million). The decrease in amortization in the nine months ended September 30, 2024 is the result of Order Backlog ($500.0 million) and Trade Name ($202.0 million) intangible assets recognized with the PRA merger being fully amortized as of July 1, 2024. 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. On August 19, 2024, the Company acquired KCR. The acquisition resulted in the preliminary recognition of intangible assets of $30.8 million. The purchase price allocation, as of the date of acquisition, was based on a preliminary valuation and may be subject to revision. Refer to note 5. Goodwill for further details. The identifiable intangible assets are amortized over their estimated useful lives.

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