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Intangible assets and goodwill - Narrative (Details) - USD ($)
$ in Thousands
1 Months Ended 3 Months Ended 9 Months Ended 12 Months Ended 37 Months Ended
Apr. 20, 2017
Aug. 31, 2021
Dec. 31, 2019
May 31, 2019
Sep. 30, 2021
Sep. 30, 2020
Sep. 30, 2021
Sep. 30, 2020
Dec. 31, 2019
Sep. 30, 2021
Dec. 31, 2020
Aug. 23, 2018
Finite-Lived Intangible Assets                        
Amortization of acquired intangible assets         $ 14,383 $ 9,630 $ 38,411 $ 26,309        
Total allocation of IPR&D assets             576,500          
Change in indefinite-lived intangibles                   $ 0    
Goodwill         82,341   82,341     82,341 $ 82,341 $ 82,300
Changes in goodwill         0   $ 0          
Weighted Average                        
Finite-Lived Intangible Assets                        
Remaining amortization period             2 years 10 months 24 days          
Akcea                        
Finite-Lived Intangible Assets                        
Milestone payments   $ 4,000                    
Agilis Merger Agreement | Akcea                        
Finite-Lived Intangible Assets                        
Milestone payments     $ 4,000 $ 6,000     $ 4,000   $ 6,000      
Useful life     10 years                  
Emflaza asset acquisition                        
Finite-Lived Intangible Assets                        
Finite-lived intangibles $ 148,400                      
Milestone obligation payments recorded         16,800 $ 13,000 42,800 $ 28,000        
Useful life 7 years                      
Emflaza asset acquisition | Accounts payable and accrued expenses                        
Finite-Lived Intangible Assets                        
Milestone payable         $ 19,200   $ 19,200     $ 19,200