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Intangible assets and goodwill - Narrative (Details) - USD ($) $ in Thousands			1 Months Ended	3 Months Ended	4 Months Ended	12 Months Ended
	Aug. 01, 2018	Apr. 20, 2017	May 31, 2019	Dec. 31, 2018	Dec. 31, 2018	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018	Aug. 23, 2018
Finite-Lived Intangible Assets
Amortization of acquired intangible assets						$ 36,892	$ 27,650	$ 22,877
Remaining amortization period						3 years 6 months
Impairment of indefinite-lived intangibles excluding goodwill						$ 0
Goodwill						82,341	82,341
Impairment of goodwill						$ 0
Akcea
Finite-Lived Intangible Assets
Milestone payments							4,000
Upfront licensing fee	$ 12,000		$ 6,000				6,000	12,000
Agilis Merger Agreement | Akcea
Finite-Lived Intangible Assets
Useful life			10 years			10 years
Milestone payments			$ 6,000				4,000
Emflaza asset acquisition
Finite-Lived Intangible Assets
Finite-lived intangibles		$ 148,400
Useful life		7 years
Milestone payments						$ 40,900	27,100	14,400
Marathon Pharmaceuticals, LLC
Finite-Lived Intangible Assets
Development milestone payment obligations						14,200
Agilis
Finite-Lived Intangible Assets
Development milestone payment obligations						40,000
Goodwill				$ 82,341	$ 82,341	82,300	$ 82,300	82,341	$ 100,309
Goodwill adjustment				18,000	(17,968)
Impairment of goodwill						0
Agilis | Agilis Merger Agreement
Finite-Lived Intangible Assets
Development milestone payment obligations						$ 40,000			40,000
In Process Research and Development | Agilis
Finite-Lived Intangible Assets
Intangible assets, other than goodwill				$ 576,500	$ 576,500			$ 576,500	$ 480,000

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Useful life of finite-lived intangible assets, in 'PnYnMnDTnHnMnS' format, for example, 'P1Y5M13D' represents the reported fact of one year, five months, and thirteen days.

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Remaining amortization period of finite-lived intangible assets, in 'PnYnMnDTnHnMnS' format, for example, 'P1Y5M13D' represents the reported fact of one year, five months, and thirteen days.

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