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Commitments and contingencies - Narrative (Details) - USD ($) $ in Thousands		1 Months Ended				6 Months Ended
	Apr. 29, 2020	Aug. 31, 2021	Dec. 31, 2019	May 31, 2019	Aug. 31, 2018	Jun. 30, 2022	Jul. 31, 2022	Dec. 31, 2021	May 29, 2020	Jun. 30, 2016
Other Commitments
Accrued royalties						$ 34,230		$ 35,679
Akcea
Other Commitments
Upfront licensing fee					$ 12,000
Milestone payments		$ 4,000
Akcea | Maximum
Other Commitments
Milestone payments		$ 4,000
Censa
Other Commitments
Asset acquisition, development and regulatory milestones									$ 109,000
Asset acquisition, initial milestone									30,000
Censa | Maximum
Other Commitments
Asset acquisition, milestone, amount									217,500
Asset acquisition, net sales milestone									$ 160,000
Agilis Merger Agreement | Akcea
Other Commitments
Milestone payments			$ 4,000	$ 6,000
SMA License Agreement | SMA Foundation
Other Commitments
Royalty expense						16,200
Royalty payments						12,100
Accrued royalties						4,100
SMA License Agreement | SMA Foundation | Maximum
Other Commitments
Potential royalty payments due on net product sales						52,500
Agilis
Other Commitments
Development milestone payments which the entity is obligated to pay	$ 40,000					40,000
Development milestone obligation payments made						$ 2,400
Agilis | Minimum
Other Commitments
Product sales (as a percent)						2.00%
Agilis | Maximum
Other Commitments
Development milestone payments which the entity is obligated to pay						$ 60,000
Priority review voucher amount						535,000
Net sales amount						$ 150,000
Product sales (as a percent)						6.00%
Development milestone payment obligations, net of cancellation and forfeiture						$ 20,000
Contingent liability, milestone, potential achievements, priority review voucher amount, net of cancellation and forfeiture						361,000
Agilis | Rights Exchange Agreement
Other Commitments
Contingent liability cancellation and forfeiture of potential milestone payments	174,000
Development milestone payment obligations, cancellation and forfeiture	37,600
Contingent liability, cancellation and forfeiture	$ 211,600
BioElectron | Maximum
Other Commitments
Development milestone payments which the entity is obligated to pay						200,000
Marathon | Agilis Merger Agreement
Other Commitments
Development milestone payments which the entity is obligated to pay						50,000
Net product revenue | Wellcome trust
Other Commitments
Development milestone payments which the entity is obligated to pay										$ 800
Net product revenue | Wellcome trust | Maximum
Other Commitments
Development milestone payments which the entity is obligated to pay						$ 22,400
Subsequent Event [Member] | Agilis
Other Commitments
Development milestone payment obligations							$ 50,000

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