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Taxation - Narrative (Details) - USD ($) $ in Thousands | 12 Months Ended
--- | ---
Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020
Taxation [Line Items] |  |  |
Percentage vote and value of subsidiaries included in the Group consolidated federal tax return | 80.00% | 80.00% | 80.00%
Percentage vote and value of subsidiaries in the Group consolidated state tax return | 50.00% | 50.00% | 50.00%
Income tax expense/(benefit) | $ (55,719) | $ 3,756 | $ 14,401
Total deferred income tax expense/(benefit) | (70,120) | (18,491) | (7,395)
Total current income tax expense/(benefit) | 14,401 | 22,247 | 21,796
UNITED STATES |  |  |
Taxation [Line Items] |  |  |
Deferred tax assets (liabilities), net, not recognized | 92,962 | 72,843 |
Federal |  |  |
Taxation [Line Items] |  |  |
Total deferred income tax expense/(benefit) | (48,240) | (15,416) | (7,349)
Total current income tax expense/(benefit) | 13,065 | 22,138 | 21,796
Tax Losses | 219,500 | 215,400 | 169,700
Tax Credits | 4,500 | 3,900 | 3,900
Unused federal orphan drug tax credits | 6,100 | 5,700 |
Federal | Operating loss carryforwards not subject to expiration |  |  |
Taxation [Line Items] |  |  |
Tax Losses | 152,700 |  |
MASSACHUSETTS |  |  |
Taxation [Line Items] |  |  |
Tax Losses | 71,700 | 27,900 | 67,400
Tax Credits | $ 600 | $ 1,300 | $ 2,100

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