Goodwill and other intangible assets - Components of intangible assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Finite-Lived Intangible Assets [Line Items]
Intangible Assets, Gross (Excluding Goodwill)	$ 3,534,799	$ 3,011,084
Accumulated Amortization	(1,015,053)	(854,799)
In-process research and development
Finite-Lived Intangible Assets [Line Items]
Indefinite lived intangible assets	29,627	27,940
Customer relationships
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	1,377,943	1,021,852
Accumulated Amortization	(425,692)	(367,585)
Intellectual property
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	1,458,924	1,351,990
Accumulated Amortization	(479,612)	(402,340)
Distribution rights
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	23,866	23,369
Accumulated Amortization	(20,280)	(18,859)
Trade names
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	619,847	563,315
Accumulated Amortization	(65,955)	(50,718)
Non-compete agreements
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	24,592	22,618
Accumulated Amortization	$ (23,514)	$ (15,297)