v3.26.1
Intangible assets - Schedule of Carrying Amount of Intangible Assets (Details) - USD ($)
$ in Thousands
Jun. 30, 2026
Dec. 31, 2025
Cost    
Total cost $ 4,967,275 $ 5,207,518
Accumulated amortization (1,820,777) (1,873,663)
Impairment 0 (86,737)
Net book value 3,146,498 3,247,118
Customer relationships    
Cost    
Total cost 4,114,183 4,134,478
Order backlog    
Cost    
Total cost 544,492 546,054
Trade names & brands    
Cost    
Total cost 189,685 204,721
Patient database    
Cost    
Total cost 2,457 170,511
Technology assets    
Cost    
Total cost $ 116,458 $ 151,754