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Intangible Assets
 12 Months Ended
Dec. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]  
Intangible Assets Intangible Assets
The carrying amount of Intangible Assets for the years ended December 31, 2024 and 2023 is as follows:
December 31, 2024December 31, 2023
Cost(in thousands)
Customer relationships$4,129,501 $4,090,393 
Order backlog543,933 541,302 
Trade names & brands204,588 204,653 
Patient database170,324 170,366 
Technology assets150,658 141,257 
Total cost5,199,004 5,147,971 
Accumulated amortization(1,639,212)(1,292,106)
Net book value$3,559,792 $3,855,865 
The amortization expense recognized by the Company was $350.3 million, $459.9 million, and $463.1 million for the years ended December 31, 2024, 2023, and 2022, respectively. The decrease in amortization in the twelve months ended December 31, 2024 is due to the order backlog and trade name intangible assets recognized in connection with the PRA merger amounting to $500.0 million and $202.0 million respectively as of the date of acquisition, becoming fully amortized on July 1, 2024.

On August 19, 2024, the Company acquired KCR. The acquisition resulted in the recognition of intangible assets of $45.1 million, comprising customer relationships of $41.4 million and order backlog of $3.7 million. These assets will be amortized over their expected useful lives of 13 years and 5 years respectively. In total, $1.3 million has been amortized in the period since the date of acquisition. Refer to note 6. Business Combinations.

On January 9, 2024, the Company acquired HumanFirst. The acquisition resulted in the recognition of a developed technology intangible asset of $9.9 million which will be amortized over its expected useful life of 5 years. In total, $2.0 million has been amortized in the period since the date of acquisition. Refer to note 6. Business Combinations.

On October 2, 2023, the Company acquired BioTel Research LLC (“BioTel”). The acquisition resulted in the recognition of intangible assets of $36.4 million, comprising customer relationships of $12.5 million, order backlog of $3.9 million and developed technology assets of $20.0 million. These assets will be amortized over their expected useful lives of between 3 years and 16 years. $6.1 million has been amortized during the twelve months ended December 31, 2024 (December 31, 2023: $1.5 million). Refer to note 6. Business Combinations.

Future intangible asset amortization expense for the years ended December 31, 2025 to December 31, 2029 is as follows:
(in thousands)
2025$235,011 
2026220,771 
2027208,448 
2028195,447 
2029180,201 
Total$1,039,878