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Commitments and contingencies - Narrative (Details) - USD ($)
$ in Thousands
 3 Months Ended 6 Months Ended 12 Months Ended
Apr. 29, 2020
Jun. 30, 2023
Jun. 30, 2016
Jun. 30, 2023
Dec. 31, 2022
Jun. 30, 2022
May 29, 2020
Other Commitments              
Milestone payable   $ 2,500   $ 2,500   $ 50,000  
Accrued royalties   51,720   51,720 $ 40,546    
Wellcome Trust              
Other Commitments              
Development milestone payment obligations         2,500    
Milestone obligation payments made     $ 800        
Censa              
Other Commitments              
Asset acquisition, development and regulatory milestones             $ 109,000
Censa | Maximum              
Other Commitments              
Asset acquisition, milestone, amount             217,500
Asset acquisition, net sales milestone             $ 160,000
Former Censa Securityholders              
Other Commitments              
Development milestone obligation payments made   30,000          
Development milestone obligation cash payments made   $ 400          
Shares issued for milestone payment   657,462          
SMA License Agreement | SMA Foundation              
Other Commitments              
Royalty expense       35,200      
Royalty payments       24,500      
Accrued royalties   $ 10,700   10,700      
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   40,000      
Potential developmental and regulatory milestones   31,100   31,100      
Potential sales milestones   $ 50,000   50,000      
Milestone obligation payments made         $ 50,000    
Development milestone obligation payments made       $ 2,400      
Agilis | Minimum              
Other Commitments              
Product sales (as a percent)   2.00%   2.00%      
Agilis | Maximum              
Other Commitments              
Development milestone payments which the entity is obligated to pay   $ 60,000   $ 60,000      
Priority review voucher amount       535,000      
Potential sales milestones   $ 150,000   $ 150,000      
Product sales (as a percent)   6.00%   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   200,000      
Marathon | Agilis Merger Agreement              
Other Commitments              
Milestone obligation payments made       50,000      
Net product revenue | Wellcome Trust | Maximum              
Other Commitments              
Development milestone payments which the entity is obligated to pay   $ 14,500   $ 14,500