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Intangible assets and goodwill - Definite-lived Intangibles (Details) - USD ($)
$ in Thousands
 3 Months Ended 6 Months Ended
Jun. 30, 2023
Jun. 30, 2022
Jun. 30, 2023
Jun. 30, 2022
Dec. 31, 2022
Definite-lived intangible assets          
Milestone Payable $ 2,500 $ 50,000 $ 2,500 $ 50,000  
Accrued royalties 51,720   51,720   $ 40,546
Definite-lived intangibles          
Amortization (47,397) (26,294) (86,812) (49,767)  
Finite-Lived Intangible Assets, Net $ 215,863   $ 215,863    
Weighted Average          
Definite-lived intangible assets          
Remaining amortization period 5 years   5 years    
Emflaza asset acquisition          
Definite-lived intangible assets          
Milestone obligation payments recorded     $ 46,500    
Emflaza asset acquisition | Accounts payable and accrued expenses          
Definite-lived intangible assets          
Milestone Payable $ 35,300   35,300    
Akcea | Waylivra          
Definite-lived intangible assets          
Royalty payments     0    
Akcea | Tegsedi          
Definite-lived intangible assets          
Royalty payments     3,500    
Akcea | Tegsedi | Accounts payable and accrued expenses          
Definite-lived intangible assets          
Accrued royalties 1,600   1,600    
Definite-lived intangible assets          
Definite-lived intangibles          
Beginning balance - Definite-lived assets, Gross     526,228    
Additions     50,026    
Foreign Currency Translation     462    
Ending balance - Definite-lived assets, Gross 576,716   576,716    
Beginning balance - Accumulated amortization     (273,903)    
Amortization (47,400) $ (26,300) (86,812) $ (49,800)  
Foreign Currency Translation - Accumulated amortization     (138)    
Ending balance - Accumulated amortization (360,853)   (360,853)    
Finite-Lived Intangible Assets, Net 215,863   215,863    
Definite-lived intangible assets | Emflaza          
Definite-lived intangibles          
Beginning balance - Definite-lived assets, Gross     420,253    
Additions     46,538    
Ending balance - Definite-lived assets, Gross 466,791   466,791    
Beginning balance - Accumulated amortization     (266,023)    
Amortization     (81,908)    
Ending balance - Accumulated amortization (347,931)   (347,931)    
Definite-lived intangible assets | Waylivra          
Definite-lived intangibles          
Beginning balance - Definite-lived assets, Gross     9,316    
Foreign Currency Translation     252    
Ending balance - Definite-lived assets, Gross 9,568   9,568    
Beginning balance - Accumulated amortization     (2,751)    
Amortization     (524)    
Foreign Currency Translation - Accumulated amortization     (81)    
Ending balance - Accumulated amortization (3,356)   (3,356)    
Definite-lived intangible assets | Tegsedi          
Definite-lived intangibles          
Beginning balance - Definite-lived assets, Gross     7,109    
Additions     3,488    
Foreign Currency Translation     210    
Ending balance - Definite-lived assets, Gross 10,807   10,807    
Beginning balance - Accumulated amortization     (1,709)    
Amortization     (649)    
Foreign Currency Translation - Accumulated amortization     (57)    
Ending balance - Accumulated amortization (2,415)   (2,415)    
Definite-lived intangible assets | Upstaza          
Definite-lived intangibles          
Beginning balance - Definite-lived assets, Gross     89,550    
Ending balance - Definite-lived assets, Gross 89,550   89,550    
Beginning balance - Accumulated amortization     (3,420)    
Amortization     (3,731)    
Ending balance - Accumulated amortization $ (7,151)   $ (7,151)