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Intangible assets and goodwill - Definite-lived Intangibles (Details) - USD ($)
$ in Thousands
 3 Months Ended 6 Months Ended
Jun. 30, 2024
Jun. 30, 2023
Jun. 30, 2024
Jun. 30, 2023
Dec. 31, 2023
Definite-lived intangible assets          
Milestone Payable $ 37,500 $ 2,500 $ 37,500 $ 2,500  
Accrued royalties 14,942   14,942   $ 74,111
Definite-lived intangibles          
Amortization (2,865) (47,397) (54,395) (86,812)  
Finite-Lived Intangible Assets, Net $ 94,113   $ 94,113    
Weighted Average          
Definite-lived intangible assets          
Remaining amortization period 9 years   9 years    
Akcea | Waylivra          
Definite-lived intangible assets          
Royalty payments     $ 2,100    
Akcea | Waylivra | Accounts payable and accrued expenses          
Definite-lived intangible assets          
Accrued royalties $ 500   500    
Akcea | Tegsedi          
Definite-lived intangible assets          
Royalty payments     3,100    
Akcea | Tegsedi | Accounts payable and accrued expenses          
Definite-lived intangible assets          
Accrued royalties 2,700   2,700    
Definite-lived intangible assets          
Definite-lived intangibles          
Beginning balance - Definite-lived assets, Gross     640,507    
Additions     5,279    
Foreign Currency Translation     (746)    
Ending balance - Definite-lived assets, Gross 645,040   645,040    
Beginning balance - Accumulated amortization     (496,776)    
Amortization (2,900) $ 47,400 (54,395) $ 86,800  
Foreign Currency Translation - Accumulated amortization     244    
Ending balance - Accumulated amortization (550,927)   (550,927)    
Finite-Lived Intangible Assets, Net 94,113   94,113    
Definite-lived intangible assets | Emflaza          
Definite-lived intangibles          
Beginning balance - Definite-lived assets, Gross     527,417    
Ending balance - Definite-lived assets, Gross 527,417   527,417    
Beginning balance - Accumulated amortization     (478,618)    
Amortization     (48,799)    
Ending balance - Accumulated amortization (527,417)   (527,417)    
Definite-lived intangible assets | Waylivra          
Definite-lived intangibles          
Beginning balance - Definite-lived assets, Gross     10,218    
Additions     2,130    
Foreign Currency Translation     (324)    
Ending balance - Definite-lived assets, Gross 12,024   12,024    
Beginning balance - Accumulated amortization     (3,965)    
Amortization     (756)    
Foreign Currency Translation - Accumulated amortization     131    
Ending balance - Accumulated amortization (4,590)   (4,590)    
Definite-lived intangible assets | Tegsedi          
Definite-lived intangibles          
Beginning balance - Definite-lived assets, Gross     13,322    
Additions     3,149    
Foreign Currency Translation     (422)    
Ending balance - Definite-lived assets, Gross 16,049   16,049    
Beginning balance - Accumulated amortization     (3,311)    
Amortization     (1,108)    
Foreign Currency Translation - Accumulated amortization     113    
Ending balance - Accumulated amortization (4,306)   (4,306)    
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     (10,882)    
Amortization     (3,732)    
Ending balance - Accumulated amortization $ (14,614)   $ (14,614)