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Intangible assets and goodwill - Narrative (Details) - USD ($) $ in Thousands		1 Months Ended			3 Months Ended	12 Months Ended
	Apr. 20, 2017	Aug. 31, 2021	Dec. 31, 2019	May 31, 2019	Dec. 31, 2018	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Finite-Lived Intangible Assets
Amortization of intangible assets						$ 54,751	$ 36,892	$ 27,650
Accrued royalties						35,679	16,575
Goodwill						$ 82,341	82,341
Weighted Average [Member]
Finite-Lived Intangible Assets
Remaining amortization period						2 years 6 months
Akcea
Finite-Lived Intangible Assets
Milestone payments								4,000
Useful life						10 years
Akcea | Waylivra
Finite-Lived Intangible Assets
Milestone payments		$ 4,000		$ 6,000
Akcea | Tegsedi
Finite-Lived Intangible Assets
Milestone payments			$ 4,000
Royalty payments						$ 200	0	0
Akcea | Accounts payable and accrued expenses | Tegsedi
Finite-Lived Intangible Assets
Accrued royalties						200
Agilis
Finite-Lived Intangible Assets
Development milestone payments which the entity is obligated to pay						40,000
Goodwill					$ 82,300	82,300	82,300
Goodwill adjustment					18,000
Agilis | In Process Research and Development
Finite-Lived Intangible Assets
Indefinite-lived intangible assets					$ 576,500
Emflaza asset acquisition
Finite-Lived Intangible Assets
Finite-lived intangibles	$ 148,400
Milestone obligation payments recorded						61,100	$ 40,900	$ 27,100
Useful life	7 years
Emflaza asset acquisition | Accounts payable and accrued expenses
Finite-Lived Intangible Assets
Milestone payable						$ 22,100

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Amount of milestone obligation payments recorded during the period.

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Amount of intangible assets, excluding goodwill, acquired at the acquisition date.

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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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