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Commitments and contingencies - Narrative (Details)
$ / shares in Units, $ in Thousands
3 Months Ended 12 Months Ended
Apr. 29, 2020
USD ($)
Mar. 31, 2023
USD ($)
D
$ / shares
Jun. 30, 2016
USD ($)
Dec. 31, 2022
USD ($)
May 29, 2020
USD ($)
Other Commitments          
Milestone payable   $ 32,500      
Accrued royalties   32,694   $ 40,546  
Wellcome Trust          
Other Commitments          
Development milestone payment obligations       2,500  
Milestone obligation payments made     $ 800    
Censa          
Other Commitments          
Milestone payable opted to be paid through issuance of common stock   $ 30,000      
Weighted average stock price | $ / shares   $ 44.9748      
Consecutive trading days used in determining weighted average stock price | D   30      
Asset acquisition, development and regulatory milestones         $ 109,000
Asset acquisition, initial milestone         30,000
Censa | Maximum          
Other Commitments          
Asset acquisition, milestone, amount         217,500
Asset acquisition, net sales milestone         $ 160,000
Censa | Accounts payable and accrued expenses          
Other Commitments          
Milestone payable   $ 30,000      
SMA License Agreement | SMA Foundation          
Other Commitments          
Royalty expense   31,600      
Royalty payments   24,500      
Accrued royalties   7,100      
SMA License Agreement | SMA Foundation | Maximum          
Other Commitments          
Potential royalty payments due on net product sales   52,500      
Agilis          
Other Commitments          
Development milestone payments which the entity is obligated to pay $ 40,000 40,000      
Potential developmental and regulatory milestones   331,000      
Potential sales milestones   150,000      
Milestone obligation payments made       $ 50,000  
Development milestone obligation payments made   $ 2,400      
Agilis | Minimum          
Other Commitments          
Product sales (as a percent)   2.00%      
Agilis | Maximum          
Other Commitments          
Development milestone payments which the entity is obligated to pay   $ 60,000      
Priority review voucher amount   535,000      
Potential sales milestones   $ 150,000      
Product sales (as a percent)   6.00%      
Development milestone payment obligations, net of cancellation and forfeiture   $ 20,000      
Contingent liability, milestone, potential achievements, priority review voucher amount, net of cancellation and forfeiture   361,000      
Agilis | Rights Exchange Agreement          
Other Commitments          
Contingent liability cancellation and forfeiture of potential milestone payments 174,000        
Development milestone payment obligations, cancellation and forfeiture 37,600        
Contingent liability, cancellation and forfeiture $ 211,600        
BioElectron | Maximum          
Other Commitments          
Development milestone payments which the entity is obligated to pay   200,000      
Marathon | Agilis Merger Agreement          
Other Commitments          
Milestone obligation payments made   50,000      
Net product revenue | Wellcome Trust | Maximum          
Other Commitments          
Development milestone payments which the entity is obligated to pay   $ 14,500