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Fair value of financial instruments and investments - Hierarchy (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Financial assets and liabilities measured at fair value on recurring basis
Marketable securities - available for sale	$ 1,625	$ 22,610
Contingent consideration payable	39,000	164,000
Transfers of assets measured between Level 1, Level 2, and Level 3	0	0
Recurring basis
Financial assets and liabilities measured at fair value on recurring basis
ClearPoint Equity Investments	4,482	10,965
ClearPoint convertible debt security	10,637	15,231
Recurring basis | Quoted prices in active markets for identical assets (Level 1)
Financial assets and liabilities measured at fair value on recurring basis
ClearPoint Equity Investments	4,482	10,965
Recurring basis | Significant other observable inputs (Level 2)
Financial assets and liabilities measured at fair value on recurring basis
ClearPoint convertible debt security	10,637	15,231
Recurring basis | Development and Regulatory Milestones
Financial assets and liabilities measured at fair value on recurring basis
Contingent consideration payable	26,400	82,500
Recurring basis | Development and Regulatory Milestones | Significant unobservable inputs (Level 3)
Financial assets and liabilities measured at fair value on recurring basis
Contingent consideration payable	26,400	82,500
Recurring basis | Net Sales Milestones and Royalties
Financial assets and liabilities measured at fair value on recurring basis
Contingent consideration payable	12,600	81,500
Recurring basis | Net Sales Milestones and Royalties | Significant unobservable inputs (Level 3)
Financial assets and liabilities measured at fair value on recurring basis
Contingent consideration payable	12,600	81,500
Recurring basis | Marketable securities
Financial assets and liabilities measured at fair value on recurring basis
Marketable securities - available for sale	1,625	22,610
Marketable securities - equity investments	128,028	108,261
Recurring basis | Marketable securities | Quoted prices in active markets for identical assets (Level 1)
Financial assets and liabilities measured at fair value on recurring basis
Marketable securities - equity investments	128,028	108,261
Recurring basis | Marketable securities | Significant other observable inputs (Level 2)
Financial assets and liabilities measured at fair value on recurring basis
Marketable securities - available for sale	$ 1,625	$ 22,610

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Amount of investment in debt security measured at fair value with change in fair value recognized in other comprehensive income (available-for-sale).

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