Intangible assets - Schedule of Carrying Amount of Intangible Assets (Details) - USD ($) $ in Thousands |
Dec. 31, 2025 |
Dec. 31, 2024 |
Dec. 31, 2023 |
|---|---|---|---|
| Intangible Asset, Acquired, Finite-Lived [Line Items] | |||
| Total cost | $ 5,207,518 | $ 5,199,004 | $ 5,147,971 |
| Accumulated amortization | (1,873,663) | (1,639,212) | (1,292,106) |
| Impairment | (86,737) | 0 | 0 |
| Net book value | 3,247,118 | 3,559,792 | 3,855,865 |
| Customer relationships | |||
| Intangible Asset, Acquired, Finite-Lived [Line Items] | |||
| Total cost | 4,134,478 | 4,129,501 | 4,090,393 |
| Order backlog | |||
| Intangible Asset, Acquired, Finite-Lived [Line Items] | |||
| Total cost | 546,054 | 543,933 | 541,302 |
| Trade names & brands | |||
| Intangible Asset, Acquired, Finite-Lived [Line Items] | |||
| Total cost | 204,721 | 204,588 | 204,653 |
| Patient database | |||
| Intangible Asset, Acquired, Finite-Lived [Line Items] | |||
| Total cost | 170,511 | 170,324 | 170,366 |
| Technology assets | |||
| Intangible Asset, Acquired, Finite-Lived [Line Items] | |||
| Total cost | $ 151,754 | $ 150,658 | $ 141,257 |