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Summary of significant accounting policies - Narrative (Details)
$ in Thousands
 1 Months Ended 3 Months Ended 9 Months Ended 12 Months Ended
Dec. 22, 2017
May 31, 2023
USD ($)
Jun. 30, 2022
USD ($)
Jul. 31, 2020
USD ($)
Sep. 30, 2023
USD ($)
country
segment
Sep. 30, 2022
USD ($)
segment
country
Sep. 30, 2023
USD ($)
country
segment
Sep. 30, 2022
USD ($)
segment
country
Dec. 31, 2019
USD ($)
Mar. 31, 2023
USD ($)
Dec. 31, 2022
USD ($)
Dec. 31, 2018
USD ($)
New Accounting Pronouncements or Change in Accounting Principle [Line Items]                        
Number of operating segments | segment         1 1 1 1        
Allowance for credit loss         $ 0 $ 0 $ 0 $ 0        
Increase in allowance for credit losses         0 0 0 0        
Allowance for doubtful accounts receivable         1,000   1,000       $ 300  
Bad debt expense         400   700          
Revenue         196,576 $ 217,127 630,766 $ 531,389        
Cash consideration received from Royalty Purchase Agreement       $ 650,000                
Income taxes                        
Federal income tax statutory rate 21.00%                      
Deferred tax benefit   $ 50,900         50,909          
Impairment of indefinite-lived intangibles excluding goodwill             217,800          
PTC-FA and PTC-AS                        
Income taxes                        
Impairment of indefinite-lived intangibles excluding goodwill             217,800          
Indefinite-lived intangible assets                        
Income taxes                        
Impairment of indefinite-lived intangibles excluding goodwill             217,800          
Indefinite-lived intangible assets | PTC-FA and PTC-AS                        
Income taxes                        
Impairment of indefinite-lived intangibles excluding goodwill             217,800          
Agilis                        
Income taxes                        
Deferred tax liability                       $ 122,000
Deposits and other assets                        
New Accounting Pronouncements or Change in Accounting Principle [Line Items]                        
Bank guarantee         $ 600   $ 600          
Blackstone Credit Agreement                        
New Accounting Pronouncements or Change in Accounting Principle [Line Items]                        
Credit agreement reserve                   $ 50,000    
Hopewell Campus                        
New Accounting Pronouncements or Change in Accounting Principle [Line Items]                        
Period after which letter of credit may be reduced if lease is not in default                 5 years      
Hopewell Campus | Minimum                        
New Accounting Pronouncements or Change in Accounting Principle [Line Items]                        
Term for letter of credit (in years)                 5 years      
Hopewell Campus | Deposits and other assets                        
New Accounting Pronouncements or Change in Accounting Principle [Line Items]                        
Letters of credit                 $ 7,500      
Hopewell Campus | Fifth Anniversary                        
New Accounting Pronouncements or Change in Accounting Principle [Line Items]                        
Letters of credit                 $ 3,800      
Warren Premises                        
New Accounting Pronouncements or Change in Accounting Principle [Line Items]                        
Period after which letter of credit may be reduced if lease is not in default     5 years                  
Warren Premises | Deposits and other assets                        
New Accounting Pronouncements or Change in Accounting Principle [Line Items]                        
Letters of credit     $ 8,100                  
Warren Premises | Fifth Anniversary                        
New Accounting Pronouncements or Change in Accounting Principle [Line Items]                        
Letters of credit     $ 4,100                  
Net product revenue | United States                        
New Accounting Pronouncements or Change in Accounting Principle [Line Items]                        
Number of countries exceeding 10% of net product sales | country         1              
Net product revenue | Geographic concentration risk                        
New Accounting Pronouncements or Change in Accounting Principle [Line Items]                        
Number of countries exceeding 10% of net product sales | country         1 2 3 2        
Percentage of net product sales threshold         10.00% 10.00% 10.00% 10.00%        
Net product revenue | Geographic concentration risk | Russia                        
New Accounting Pronouncements or Change in Accounting Principle [Line Items]                        
Revenue           $ 28,300 $ 69,000 $ 57,100        
Net product revenue | Geographic concentration risk | Brazil                        
New Accounting Pronouncements or Change in Accounting Principle [Line Items]                        
Revenue             52,500          
Net product revenue | Geographic concentration risk | United States                        
New Accounting Pronouncements or Change in Accounting Principle [Line Items]                        
Revenue         $ 67,400 54,800 187,700 160,100        
Net product revenue                        
New Accounting Pronouncements or Change in Accounting Principle [Line Items]                        
Revenue         144,038 134,186 506,187 407,720        
Net product revenue | Non-US                        
New Accounting Pronouncements or Change in Accounting Principle [Line Items]                        
Revenue         76,600 79,400 318,500 247,600        
Emflaza | United States                        
New Accounting Pronouncements or Change in Accounting Principle [Line Items]                        
Revenue         67,400 54,800 187,700 160,100        
Translarna | Non-US                        
New Accounting Pronouncements or Change in Accounting Principle [Line Items]                        
Revenue         $ 69,000 $ 76,600 $ 280,600 $ 232,900