v3.25.2
Intangible assets - Schedule of Finite-Lived Intangible Assets (Details) - USD ($)
$ in Thousands
Jun. 30, 2025
Dec. 31, 2024
Cost    
Total cost $ 5,207,473 $ 5,199,004
Accumulated amortization (1,764,377) (1,639,212)
 Net book value 3,443,096 3,559,792
Customer relationships    
Cost    
Total cost 4,134,482 4,129,501
Order backlog    
Cost    
Total cost 545,993 543,933
Trade names & brands    
Cost    
Total cost 204,717 204,588
Patient database    
Cost    
Total cost 170,563 170,324
Technology assets    
Cost    
Total cost $ 151,718 $ 150,658