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Intangible assets and goodwill - Definite-lived Intangibles (Details) - USD ($)
$ in Thousands
 1 Months Ended 12 Months Ended
Nov. 30, 2024
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Definite-lived intangible assets        
Accrued royalties   $ 8,953 $ 74,111  
Definite-lived intangibles        
Amortization   (60,738) (222,635) $ (116,554)
Finite-Lived Intangible Assets, Net   $ 118,794    
Weighted Average        
Definite-lived intangible assets        
Remaining amortization period   9 years 3 months 18 days    
Kebilidi        
Definite-lived intangibles        
Reclass from Indefinite Lived to Definite Lived $ 10,700      
Useful life 12 years      
Upstaza        
Definite-lived intangibles        
Reclass from Indefinite Lived to Definite Lived $ 17,400      
Useful life 12 years      
Akcea | Waylivra        
Definite-lived intangible assets        
Royalty payments   $ 2,900    
Akcea | Tegsedi        
Definite-lived intangible assets        
Royalty payments   5,900    
Definite-lived intangible assets        
Definite-lived intangibles        
Beginning balance - Definite-lived assets, Gross   640,507    
Additions   8,810    
Reclass from Indefinite Lived to Definite Lived   28,118    
Foreign Currency Translation   (1,704)    
Ending balance - Definite-lived assets, Gross   675,731 640,507  
Beginning balance - Accumulated amortization   (496,776)    
Amortization   (60,738)    
Foreign Currency Translation - Accumulated amortization   577    
Ending balance - Accumulated amortization   (556,937) (496,776)  
Finite-Lived Intangible Assets, Net   118,794    
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) (478,618)  
Definite-lived intangible assets | Waylivra        
Definite-lived intangibles        
Beginning balance - Definite-lived assets, Gross   10,218    
Additions   2,874    
Foreign Currency Translation   (695)    
Ending balance - Definite-lived assets, Gross   12,397 10,218  
Beginning balance - Accumulated amortization   (3,965)    
Amortization   (1,602)    
Foreign Currency Translation - Accumulated amortization   294    
Ending balance - Accumulated amortization   (5,273) (3,965)  
Definite-lived intangible assets | Kebilidi        
Definite-lived intangibles        
Reclass from Indefinite Lived to Definite Lived   10,731    
Ending balance - Definite-lived assets, Gross   10,731    
Amortization   (112)    
Ending balance - Accumulated amortization   (112)    
Definite-lived intangible assets | Upstaza        
Definite-lived intangibles        
Beginning balance - Definite-lived assets, Gross   89,550    
Reclass from Indefinite Lived to Definite Lived   17,387    
Ending balance - Definite-lived assets, Gross   106,937 89,550  
Beginning balance - Accumulated amortization   (10,882)    
Amortization   (7,644)    
Ending balance - Accumulated amortization   (18,526) (10,882)  
Definite-lived intangible assets | Tegsedi        
Definite-lived intangibles        
Beginning balance - Definite-lived assets, Gross   13,322    
Additions   5,936    
Foreign Currency Translation   (1,009)    
Ending balance - Definite-lived assets, Gross   18,249 13,322  
Beginning balance - Accumulated amortization   (3,311)    
Amortization   (2,581)    
Foreign Currency Translation - Accumulated amortization   283    
Ending balance - Accumulated amortization   $ (5,609) $ (3,311)