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Intangible assets and goodwill - Definite-lived Intangibles (Details) - USD ($)
$ in Thousands
 1 Months Ended 3 Months Ended 9 Months Ended
Jul. 31, 2025
Jun. 30, 2025
Sep. 30, 2025
Sep. 30, 2024
Sep. 30, 2025
Sep. 30, 2024
Aug. 31, 2025
Aug. 05, 2025
Dec. 31, 2024
Definite-lived intangible assets                  
Accrued royalties     $ 5,146   $ 5,146       $ 8,953
Milestone Payable     32,500 $ 50,000 32,500 $ 50,000     $ 11,025
Definite-lived intangibles                  
Amortization     (7,534) (3,036) (15,393) (57,431)      
Total definite-lived intangibles, net     $ 396,466   $ 396,466        
Weighted Average                  
Definite-lived intangible assets                  
Remaining amortization period     12 years 2 months 12 days   12 years 2 months 12 days        
Rights Satisfaction Agreement                  
Definite-lived intangible assets                  
Maximum Upfront Consideration Agreed To Be Paid             $ 225,100 $ 250,000  
Akcea | Tegsedi                  
Definite-lived intangible assets                  
Royalty payments         $ 3,400        
Akcea | Tegsedi | Accounts payable and accrued expenses                  
Definite-lived intangible assets                  
Accrued royalties     $ 1,200   1,200        
Akcea | Waylivra                  
Definite-lived intangible assets                  
Royalty payments         4,300        
Akcea | Waylivra | Accounts payable and accrued expenses                  
Definite-lived intangible assets                  
Accrued royalties     900   900        
Censa | Sephience                  
Definite-lived intangible assets                  
Royalty payments         200        
Accrued royalties     200   200        
Censa | Censa Merger Agreement                  
Definite-lived intangible assets                  
Milestone obligation payments recorded $ 32,500 $ 25,000              
Milestone Payable $ 32,500   32,500   32,500        
Definite-lived intangible assets                  
Definite-lived intangibles                  
Beginning balance - Definite-lived assets, Gross         148,314        
Additions         290,501        
Foreign currency translation         4,076        
Ending balance - Definite-lived assets, Gross     442,891   442,891        
Beginning balance - Accumulated amortization         (29,520)        
Amortization     (7,500) $ (3,000) (15,393) $ (57,400)      
Foreign currency translation - Accumulated amortization         (1,512)        
Ending balance - Accumulated amortization     (46,425)   (46,425)        
Total definite-lived intangibles, net     396,466   396,466        
Definite-lived intangible assets | Tegsedi                  
Definite-lived intangibles                  
Beginning balance - Definite-lived assets, Gross         18,249        
Additions         3,448        
Foreign currency translation         2,367        
Ending balance - Definite-lived assets, Gross     24,064   24,064        
Beginning balance - Accumulated amortization         (5,609)        
Amortization         (2,774)        
Foreign currency translation - Accumulated amortization         (791)        
Ending balance - Accumulated amortization     (9,174)   (9,174)        
Definite-lived intangible assets | Waylivra                  
Definite-lived intangibles                  
Beginning balance - Definite-lived assets, Gross         12,397        
Additions         4,290        
Foreign currency translation         1,709        
Ending balance - Definite-lived assets, Gross     18,396   18,396        
Beginning balance - Accumulated amortization         (5,273)        
Amortization         (1,921)        
Foreign currency translation - Accumulated amortization         (721)        
Ending balance - Accumulated amortization     (7,915)   (7,915)        
Definite-lived intangible assets | Kebilidi                  
Definite-lived intangibles                  
Beginning balance - Definite-lived assets, Gross         10,731        
Ending balance - Definite-lived assets, Gross     10,731   10,731        
Beginning balance - Accumulated amortization         (112)        
Amortization         (671)        
Ending balance - Accumulated amortization     (783)   (783)        
Definite-lived intangible assets | Upstaza                  
Definite-lived intangibles                  
Beginning balance - Definite-lived assets, Gross         106,937        
Ending balance - Definite-lived assets, Gross     106,937   106,937        
Beginning balance - Accumulated amortization         (18,526)        
Amortization         (6,684)        
Ending balance - Accumulated amortization     (25,210)   (25,210)        
Definite-lived intangible assets | Sephience                  
Definite-lived intangibles                  
Additions         282,763        
Ending balance - Definite-lived assets, Gross     282,763   282,763        
Amortization         (3,343)        
Ending balance - Accumulated amortization     $ (3,343)   $ (3,343)