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Intangible assets and goodwill - Definite-lived Intangibles (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Definite-lived intangible assets      
Accrued royalties $ 40,546 $ 35,679  
Definite-lived intangibles      
Amortization (116,554) (54,751) $ (36,892)
Finite-Lived Intangible Assets, Net $ 252,325    
Weighted Average      
Definite-lived intangible assets      
Remaining amortization period 4 years 10 months 24 days    
Emflaza asset acquisition      
Definite-lived intangible assets      
Milestone obligation payments recorded $ 128,400    
Emflaza asset acquisition | Accounts payable and accrued expenses      
Definite-lived intangible assets      
Milestone Payable 32,800    
Emflaza asset acquisition | Sales Milestones      
Definite-lived intangible assets      
Milestone obligation payments recorded 50,000    
Akcea | Tegsedi      
Definite-lived intangible assets      
Royalty payments 3,200    
Akcea | Tegsedi | Accounts payable and accrued expenses      
Definite-lived intangible assets      
Accrued royalties 500    
Definite-lived intangible assets      
Definite-lived intangibles      
Beginning balance - Definite-lived assets, Gross 305,839    
Additions 131,618    
Reclass from Indefinite Lived to Definite Lived 89,550    
Foreign Currency Translation (779)    
Ending balance - Definite-lived assets, Gross 526,228 305,839  
Beginning balance - Accumulated amortization (157,498)    
Amortization (116,554)    
Foreign Currency Translation - Accumulated amortization 149    
Ending balance - Accumulated amortization (273,903) (157,498)  
Finite-Lived Intangible Assets, Net 252,325    
Definite-lived intangible assets | Emflaza      
Definite-lived intangibles      
Beginning balance - Definite-lived assets, Gross 291,875    
Additions 128,378    
Ending balance - Definite-lived assets, Gross 420,253 291,875  
Beginning balance - Accumulated amortization (154,594)    
Amortization (111,429)    
Ending balance - Accumulated amortization (266,023) (154,594)  
Definite-lived intangible assets | Waylivra      
Definite-lived intangibles      
Beginning balance - Definite-lived assets, Gross 9,904    
Foreign Currency Translation (588)    
Ending balance - Definite-lived assets, Gross 9,316 9,904  
Beginning balance - Accumulated amortization (1,821)    
Amortization (1,020)    
Foreign Currency Translation - Accumulated amortization 90    
Ending balance - Accumulated amortization (2,751) (1,821)  
Definite-lived intangible assets | Tegsedi      
Definite-lived intangibles      
Beginning balance - Definite-lived assets, Gross 4,060    
Additions 3,240    
Foreign Currency Translation (191)    
Ending balance - Definite-lived assets, Gross 7,109 4,060  
Beginning balance - Accumulated amortization (1,083)    
Amortization (685)    
Foreign Currency Translation - Accumulated amortization 59    
Ending balance - Accumulated amortization (1,709) $ (1,083)  
Definite-lived intangible assets | Upstaza      
Definite-lived intangibles      
Reclass from Indefinite Lived to Definite Lived 89,550    
Ending balance - Definite-lived assets, Gross 89,550    
Amortization (3,420)    
Ending balance - Accumulated amortization $ (3,420)