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Fair value of financial instruments and investments - Schedule of financial assets and liabilities (Details) - USD ($) $ in Thousands | Dec. 31, 2020 | Dec. 31, 2019 | Aug. 23, 2018
--- | --- | --- | ---
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] |  |  |
Marketable securities | $ 894,838 | $ 398,535 |
Deferred consideration payable | 0 |  |
Contingent consideration payable | 240,400 | 356,300 |
Level 2 |  |  |
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] |  |  |
ClearPoint convertible debt security | 29,300 |  |
Level 3 |  |  |
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] |  |  |
ClearPoint convertible debt security | 0 |  |
Contingent consideration payable- net sales milestones and royalties | 101,200 |  |
Recurring basis | Total |  |  |
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] |  |  |
Marketable securities | 894,838 | 398,535 |
Equity investment in ClearPoint | 20,503 | 6,194 |
ClearPoint convertible debt security | 29,252 |  |
Stock appreciation rights liability |  | 3,186 |
Deferred consideration payable |  | 40,000 |
Contingent consideration payable | 139,200 | 290,500 |
Contingent consideration payable- net sales milestones and royalties | 101,200 | 65,800 |
Recurring basis | Level 1 |  |  |
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] |  |  |
Marketable securities | 0 | 0 |
Equity investment in ClearPoint | 20,503 | 6,194 |
ClearPoint convertible debt security | 0 |  |
Stock appreciation rights liability |  | 0 |
Deferred consideration payable |  | 0 |
Contingent consideration payable | 0 | 0 |
Contingent consideration payable- net sales milestones and royalties | 0 | 0 |
Recurring basis | Level 2 |  |  |
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] |  |  |
Marketable securities | 894,838 | 398,535 |
Equity investment in ClearPoint | 0 | 0 |
ClearPoint convertible debt security | 29,252 |  |
Stock appreciation rights liability |  | 0 |
Deferred consideration payable |  | 40,000 |
Contingent consideration payable | 0 | 0 |
Contingent consideration payable- net sales milestones and royalties | 0 | 0 |
Recurring basis | Level 3 |  |  |
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] |  |  |
Marketable securities | 0 | 0 |
Equity investment in ClearPoint | 0 | 0 |
Stock appreciation rights liability |  | 3,186 |
Deferred consideration payable |  | 0 |
Contingent consideration payable | $ 139,200 | 290,500 |
Contingent consideration payable- net sales milestones and royalties |  | $ 65,800 |
Agilis |  |  |
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items] |  |  |
Deferred consideration payable |  |  | $ 38,100

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