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Commitments and contingencies - Narrative (Details) - USD ($)
$ in Millions
9 Months Ended 12 Months Ended
Sep. 30, 2019
Dec. 31, 2018
Aug. 23, 2018
Jun. 30, 2016
Akcea        
Other Commitments [Abstract]        
Upfront licensing fee $ 12.0      
Milestone payments 4.0      
Akcea | Maximum        
Other Commitments [Abstract]        
Milestone payments 8.0      
Non-collaborative Arrangement Transactions | Akcea        
Other Commitments [Abstract]        
Milestone payments 6.0      
Agilis        
Other Commitments [Abstract]        
Development milestone payments which the entity is obligated to pay   $ 40.0 $ 40.0  
Agilis | Maximum        
Other Commitments [Abstract]        
Development milestone payments which the entity is obligated to pay 60.0 60.0    
Priority review voucher amount 535.0 535.0    
Net sales amount $ 150.0 $ 150.0    
Product sales 6.00% 6.00%    
Agilis | Non-collaborative Arrangement Transactions        
Other Commitments [Abstract]        
Development milestone payments which the entity is obligated to pay $ 40.0      
Product | Wellcome trust        
Other Commitments [Abstract]        
Development milestone payments which the entity is obligated to pay       $ 0.8
Product | Wellcome trust | Maximum        
Other Commitments [Abstract]        
Development milestone payments which the entity is obligated to pay $ 22.4