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Intangible assets and goodwill - Definite-lived Intangibles (Details) - USD ($)
$ in Thousands
 3 Months Ended 9 Months Ended
Sep. 30, 2023
Sep. 30, 2022
Sep. 30, 2023
Sep. 30, 2022
Dec. 31, 2022
Definite-lived intangible assets          
Milestone Payable $ 2,500 $ 50,000 $ 2,500 $ 50,000  
Accrued royalties 52,087   52,087   $ 40,546
Definite-lived intangibles          
Amortization (58,649) (31,023) (145,461) (80,790)  
Finite-Lived Intangible Assets, Net $ 187,576   $ 187,576    
Weighted Average          
Definite-lived intangible assets          
Remaining amortization period 5 years 3 months 18 days   5 years 3 months 18 days    
Emflaza asset acquisition          
Definite-lived intangible assets          
Milestone obligation payments recorded     $ 76,500    
Marathon | Emflaza asset acquisition | Accounts payable and accrued expenses          
Definite-lived intangible assets          
Milestone Payable $ 43,900   43,900    
Akcea | Waylivra          
Definite-lived intangible assets          
Royalty payments     200    
Akcea | Waylivra | Accounts payable and accrued expenses          
Definite-lived intangible assets          
Accrued royalties 200   200    
Akcea | Tegsedi          
Definite-lived intangible assets          
Royalty payments     4,300    
Akcea | Tegsedi | Accounts payable and accrued expenses          
Definite-lived intangible assets          
Accrued royalties 900   900    
Definite-lived intangible assets          
Definite-lived intangibles          
Beginning balance - Definite-lived assets, Gross     526,228    
Additions     80,910    
Foreign Currency Translation     (279)    
Ending balance - Definite-lived assets, Gross 606,859   606,859    
Beginning balance - Accumulated amortization     (273,903)    
Amortization (58,600) $ (31,000) (145,461) $ (80,800)  
Foreign Currency Translation - Accumulated amortization     81    
Ending balance - Accumulated amortization (419,283)   (419,283)    
Finite-Lived Intangible Assets, Net 187,576   187,576    
Definite-lived intangible assets | Emflaza          
Definite-lived intangibles          
Beginning balance - Definite-lived assets, Gross     420,253    
Additions     76,454    
Ending balance - Definite-lived assets, Gross 496,707   496,707    
Beginning balance - Accumulated amortization     (266,023)    
Amortization     (138,038)    
Ending balance - Accumulated amortization (404,061)   (404,061)    
Definite-lived intangible assets | Waylivra          
Definite-lived intangibles          
Beginning balance - Definite-lived assets, Gross     9,316    
Additions     157    
Foreign Currency Translation     (96)    
Ending balance - Definite-lived assets, Gross 9,377   9,377    
Beginning balance - Accumulated amortization     (2,751)    
Amortization     (791)    
Foreign Currency Translation - Accumulated amortization     45    
Ending balance - Accumulated amortization (3,497)   (3,497)    
Definite-lived intangible assets | Tegsedi          
Definite-lived intangibles          
Beginning balance - Definite-lived assets, Gross     7,109    
Additions     4,299    
Foreign Currency Translation     (183)    
Ending balance - Definite-lived assets, Gross 11,225   11,225    
Beginning balance - Accumulated amortization     (1,709)    
Amortization     (1,035)    
Foreign Currency Translation - Accumulated amortization     36    
Ending balance - Accumulated amortization (2,708)   (2,708)    
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     (5,597)    
Ending balance - Accumulated amortization $ (9,017)   $ (9,017)