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Income taxes - Narrative (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2021
Dec. 31, 2020
Dec. 31, 2019
Operating loss carryforwards      
Taxable income before consideration of NOL $ 306,900    
State income tax provision 3,844 $ 24,984 $ 61
Deferred tax valuation allowance 525,570 379,608  
Valuation allowance, deferred tax asset, increase (decrease) 146,000 112,500  
Operating loss carryforwards limited by IRC Section 382 231,500    
Orphan Drug Credit carryover 114,600    
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 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 48,000    
Undistributed earnings from non-US subsidiaries, tax 0    
Unrecognized tax benefits 27,217 $ 2,446  
First five years from ownership change      
Operating loss carryforwards      
Net operating loss carryforwards 16,700    
After five years      
Operating loss carryforwards      
Net operating loss carryforwards 5,700    
Federal      
Operating loss carryforwards      
Net operating loss carryforwards 364,700    
Research and development credit carryforwards 28,000    
Net operating loss carryforwards limited by IRC Section 382 utilized   $ 97,700  
State      
Operating loss carryforwards      
Net operating loss carryforwards $ 136,700