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Income taxes - Narrative (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Operating loss carryforwards      
Taxable income before consideration of NOL $ 364,100    
State income tax provision 24,984 $ 61 $ 38
Valuation allowance 379,608 267,131  
Valuation allowance, deferred tax asset, increase (decrease) 112,500 $ 86,700  
Operating loss carryforwards limited by IRC Section 382 231,500    
Orphan Drug Credit carryover 107,700    
Operating loss carryforwards, not subject to expiration 169,200    
Operating loss carryforwards, subject to expiration 62,300    
Net operating loss carryforwards utilized 364,100    
Operating loss carryforwards for immediate use 9,500    
Operating loss carryforwards in next twelve months $ 5,700    
Federal income tax provision at statutory rate 21.00% 21.00% 21.00%
Uncertain tax position $ 0    
Undistributed earnings from non-US subsidiaries 16,100    
Undistributed earnings from non-US subsidiaries, tax 0    
Provisional tax benefit from corporate tax rate reductions     $ 46,100
Increase in tax positions for prior years 2,446    
First five years from ownership change      
Operating loss carryforwards      
Net operating loss carryforwards 16,700    
After five years from ownership change      
Operating loss carryforwards      
Net operating loss carryforwards 5,700    
Federal      
Operating loss carryforwards      
Net operating loss carryforwards 80,900    
Research and development credit carryforwards 15,700    
Net operating loss carryforwards limited by IRC Section 382 utilized 97,700    
State      
Operating loss carryforwards      
Net operating loss carryforwards $ 22,600