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Commitments and contingencies - Narrative (Details) - USD ($)
$ in Millions
1 Months Ended 3 Months Ended 12 Months Ended
Jun. 29, 2020
Apr. 29, 2020
Dec. 31, 2019
May 31, 2019
Mar. 31, 2021
Dec. 31, 2019
May 29, 2020
Apr. 20, 2017
Jun. 30, 2016
Akcea                  
Other Commitments                  
Upfront licensing fee         $ 12.0        
Akcea | Maximum                  
Other Commitments                  
Milestone payments         4.0        
Censa                  
Other Commitments                  
Asset acquisition, development and regulatory milestones             $ 109.0    
Asset acquisition, initial milestone             30.0    
Censa | Maximum                  
Other Commitments                  
Asset acquisition, milestone, amount             217.5    
Asset acquisition, net sales milestone             $ 160.0    
Agilis Merger Agreement | Marathon Pharmaceuticals, LLC                  
Other Commitments                  
Development milestone payments which the entity is obligated to pay               $ 50.0  
Agilis Merger Agreement | Akcea                  
Other Commitments                  
Milestone payments     $ 4.0 $ 6.0 4.0 $ 6.0      
SMA License Agreement | Maximum                  
Other Commitments                  
Potential royalty payments due on net product sales         52.5        
Agilis                  
Other Commitments                  
Development milestone payments which the entity is obligated to pay         40.0        
Development milestone obligation payments made         $ 2.4        
Agilis | Minimum                  
Other Commitments                  
Product sales (as a percent)   2.00%     2.00%        
Agilis | Maximum                  
Other Commitments                  
Development milestone payments which the entity is obligated to pay         $ 60.0        
Priority review voucher amount         535.0        
Net sales amount         $ 150.0        
Product sales (as a percent)   6.00%     6.00%        
Development milestone payment obligations, net of cancellation and forfeiture         $ 20.0        
Agilis | Rights Exchange Agreement                  
Other Commitments                  
Contingent liability cancellation and forfeiture of potential milestone payments         174.0        
Development milestone payment obligations, cancellation and forfeiture         37.6        
Contingent liability, cancellation and forfeiture $ 211.6                
Agilis | Rights Exchange Agreement | Maximum                  
Other Commitments                  
Contingent liability, milestone, potential achievements, priority review voucher amount, net of cancellation and forfeiture   $ 361.0              
BioElectron | Maximum                  
Other Commitments                  
Development milestone payments which the entity is obligated to pay         200.0        
Net product revenue | Wellcome Trust                  
Other Commitments                  
Development milestone payments which the entity is obligated to pay                 $ 0.8
Net product revenue | Wellcome Trust | Maximum                  
Other Commitments                  
Development milestone payments which the entity is obligated to pay         $ 22.4