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Intangible assets and goodwill - Definite-lived Intangibles (Details) - USD ($)
$ in Thousands
 3 Months Ended 9 Months Ended
Sep. 30, 2024
Sep. 30, 2023
Sep. 30, 2024
Sep. 30, 2023
Dec. 31, 2023
Definite-lived intangible assets          
Milestone Payable $ 50,000 $ 2,500 $ 50,000 $ 2,500  
Accrued royalties 14,016   14,016   $ 74,111
Definite-lived intangibles          
Amortization (3,036) (58,649) (57,431) (145,461)  
Finite-Lived Intangible Assets, Net $ 94,602   $ 94,602    
Weighted Average          
Definite-lived intangible assets          
Remaining amortization period 8 years 8 months 12 days   8 years 8 months 12 days    
Akcea | Waylivra          
Definite-lived intangible assets          
Royalty payments     $ 2,700    
Akcea | Waylivra | Accounts payable and accrued expenses          
Definite-lived intangible assets          
Accrued royalties $ 500   500    
Akcea | Tegsedi          
Definite-lived intangible assets          
Royalty payments     5,300    
Akcea | Tegsedi | Accounts payable and accrued expenses          
Definite-lived intangible assets          
Accrued royalties 1,900   1,900    
Definite-lived intangible assets          
Definite-lived intangibles          
Beginning balance - Definite-lived assets, Gross     640,507    
Additions     8,001    
Foreign Currency Translation     436    
Ending balance - Definite-lived assets, Gross 648,944   648,944    
Beginning balance - Accumulated amortization     (496,776)    
Amortization (3,000) $ (58,600) (57,431) $ (145,500)  
Foreign Currency Translation - Accumulated amortization     (135)    
Ending balance - Accumulated amortization (554,342)   (554,342)    
Finite-Lived Intangible Assets, Net 94,602   94,602    
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     2,732    
Foreign Currency Translation     183    
Ending balance - Definite-lived assets, Gross 13,133   13,133    
Beginning balance - Accumulated amortization     (3,965)    
Amortization     (1,187)    
Foreign Currency Translation - Accumulated amortization     (63)    
Ending balance - Accumulated amortization (5,215)   (5,215)    
Definite-lived intangible assets | Tegsedi          
Definite-lived intangibles          
Beginning balance - Definite-lived assets, Gross     13,322    
Additions     5,269    
Foreign Currency Translation     253    
Ending balance - Definite-lived assets, Gross 18,844   18,844    
Beginning balance - Accumulated amortization     (3,311)    
Amortization     (1,847)    
Foreign Currency Translation - Accumulated amortization     (72)    
Ending balance - Accumulated amortization (5,230)   (5,230)    
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     (5,598)    
Ending balance - Accumulated amortization $ (16,480)   $ (16,480)