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Intangible assets
 9 Months Ended
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 backlog544,546 541,302 
Trade names & brands204,666 204,653 
Patient database170,501 170,366 
Technology assets151,306 141,257 
Total cost5,190,134 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 year 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.