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Commitments and contingencies - Narrative (Details) - USD ($)
$ in Thousands
 1 Months Ended 12 Months Ended
Jul. 31, 2022
Dec. 31, 2023
Dec. 31, 2022
May 29, 2020
Apr. 29, 2020
Jun. 30, 2016
Other Commitments            
Milestone payable   $ 2,500        
Accrued royalties   74,111 $ 40,546      
Wellcome Trust            
Other Commitments            
Development milestone payment obligations   2,500       $ 800
Censa            
Other Commitments            
Asset acquisition, development and regulatory milestones       $ 109,000    
Development milestone obligation payments made   30,000        
Development milestone obligation cash payments made   $ 400        
Shares issued for milestone payment   657,462        
Censa | Maximum            
Other Commitments            
Asset acquisition, milestone, amount       217,500    
Asset acquisition, net sales milestone       $ 160,000    
Former Censa Securityholders            
Other Commitments            
Potential developmental and regulatory milestones   $ 65,000        
Development milestone obligation payments made   30,000        
Development milestone obligation cash payments made   $ 400        
Shares issued for milestone payment   657,462        
Agilis Merger Agreement | Marathon            
Other Commitments            
Development milestone payment obligations     $ 50,000      
SMA License Agreement | SMA Foundation            
Other Commitments            
Royalty expense   $ 52,500        
Royalty payments   35,300        
Accrued royalties   17,200        
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        
Potential developmental and regulatory milestones   31,100        
Potential sales milestones   50,000     $ 150,000  
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 payment obligations   $ 60,000        
Priority review voucher amount   535,000        
Potential sales milestones   $ 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 | Agilis Merger Agreement            
Other Commitments            
Development milestone payment obligations   40,000        
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 payment obligations   $ 200,000