v3.26.1
Intangible assets (Tables)
 12 Months Ended
Dec. 31, 2025
Goodwill and Intangible Assets Disclosure [Abstract]  
Schedule of Carrying Amount of Intangible Assets
Intangible assets are amortized on a straight-line basis over their estimated useful lives, as set forth in the table below:

Estimated Useful Life
Customer relationships
8 - 23 years
Order backlog
       3 - 5 years
Trade names3 years
Patient database7 years
Technology assets5 years
The carrying amount of intangible assets for the years ended December 31, 2025, 2024, and 2023 is as follows:
December 31, 2025December 31, 2024December 31, 2023
(in thousands)
Customer relationships$4,134,478 $4,129,501 $4,090,393 
Order backlog546,054 543,933 541,302 
Trade names & brands204,721 204,588 204,653 
Patient database170,511 170,324 170,366 
Technology assets151,754 150,658 141,257 
Total cost5,207,518 5,199,004 5,147,971 
Accumulated amortization(1,873,663)(1,639,212)(1,292,106)
Impairment(86,737)— — 
Net book value$3,247,118 $3,559,792 $3,855,865 
Schedule of Future Intangible Asset Amortization Expense
Future intangible asset amortization expense for the years ended December 31, 2026 to December 31, 2030 is as follows:
(in thousands)
2026$190,632 
2027183,567 
2028182,566 
2029177,332 
2030176,844 
Total$910,941