0000875320-23-000007 | 10-K | XBRL Viewer | Vertex Pharmaceuticals INC MA

Print Document View Excel Document

Segment Information - Property and Equipment, Net by Location (Details) - USD ($) $ in Millions	Dec. 31, 2022	Dec. 31, 2021
Revenues from External Customers and Long-Lived Assets [Line Items]
Total long-lived assets	$ 1,455.8	$ 1,424.4
United States
Revenues from External Customers and Long-Lived Assets [Line Items]
Total long-lived assets	1,365.5	1,348.1
United Kingdom
Revenues from External Customers and Long-Lived Assets [Line Items]
Total long-lived assets	75.7	60.9
Other
Revenues from External Customers and Long-Lived Assets [Line Items]
Total long-lived assets	14.6	15.4
Total long-lived assets outside of the United States
Revenues from External Customers and Long-Lived Assets [Line Items]
Total long-lived assets	$ 90.3	$ 76.3

Segment Information

12 Months Ended

Dec. 31, 2022

Segment Reporting [Abstract]

Segment Information

Segment reporting is prepared on the same basis that our chief executive officer, who is our chief operating decision maker, manages the business, makes operating decisions and assesses performance. We operate in one segment, pharmaceuticals. Enterprise-wide disclosures about revenues, significant customers, and property and equipment, net by location are presented below.

Revenues by Product

Product revenues, net consisted of the following:


	2022		2021		2020
	(in millions)
TRIKAFTA/KAFTRIO	$	7,686.8	$	5,697.2	$	3,863.8
SYMDEKO/SYMKEVI	180.0		420.4		628.6
ORKAMBI	510.7		771.6		907.5
KALYDECO	553.2		684.2		802.9
Total product revenues, net	$	8,930.7	$	7,573.4	$	6,202.8

Product Revenues by Geographic Location

Net product revenues are attributed to countries based on the location of the customer and consisted of the following:


	2022		2021		2020
	(in millions)
United States	$	5,699.3	$	5,287.3	$	4,826.4
Outside of the United States
Europe	2,705.5		1,972.9		1,126.5
Other	525.9		313.2		249.9
Total product revenues outside of the United States	3,231.4		2,286.1		1,376.4
Total product revenues, net	$	8,930.7	$	7,573.4	$	6,202.8

Significant Customers

Gross product revenues and accounts receivable from each of our customers who individually accounted for 10% or more of total gross product revenues and/or 10% or more of total accounts receivable consisted of the following:


	Percent of Total Gross Product Revenues						Percent of Accounts Receivable
	Year Ended December 31,						As of December 31,
	2022		2021		2020		2022		2021
McKesson Corporation	25	%	22	%	20	%	22	%	21	%
Accredo Health Group, Inc.	12	%	12	%	15	%	<10%		10	%
Walgreen Co.	10	%	10	%	14	%	<10%		<10 %
Lloyds Pharmacy*	<10%		<10%		<10%		12	%	15	%
*A wholly-owned subsidiary of McKesson Corporation in the U.K. until 2022.

Long-lived Assets by Location

Long-lived assets by location consisted of the following:


	As of December 31,
	2022		2021
	(in millions)
United States	$	1,365.5	$	1,348.1
Outside of the United States
United Kingdom	75.7		60.9
Other	14.6		15.4
Total long-lived assets outside of the United States	90.3		76.3
Total long-lived assets	$	1,455.8	$	1,424.4

- Definition

The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 31
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8924-108599

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 34
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8981-108599

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 21
-Subparagraph (a)
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8721-108599

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 40
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e9031-108599

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (f)
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8933-108599

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (e)
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8933-108599

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 26
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8844-108599

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 41
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e9038-108599

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (d)
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8933-108599

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 22
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8736-108599

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 42
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e9054-108599

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 15
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8657-108599

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 21
-Subparagraph (b)
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8721-108599

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-URI https://asc.fasb.org/topic&trid=2134510

+ Details

Income Taxes - Effective Income Tax Reconciliation (Details)	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Income Tax Disclosure [Abstract]
Federal statutory tax rate	21.00%	21.00%	21.00%
State taxes, net of federal benefit	0.60%	0.80%	0.60%
Foreign income tax rate differential	(0.30%)	(0.30%)	0.20%
U.S. tax on foreign earnings, net of credits	1.90%	0.70%	2.70%
Foreign derived intangible income deduction	(1.40%)	(0.80%)	(0.20%)
Tax credits	(2.20%)	(6.40%)	(1.80%)
Tax rate change	0.00%	(3.50%)	(1.20%)
Stock compensation (benefit), shortfalls and cancellations	(0.80%)	0.00%	(2.30%)
Long-term intercompany receivable write-off	0.00%	0.00%	(1.70%)
Uncertain tax positions	2.70%	2.00%	1.30%
Intra-entity transfer of intellectual property rights	0.00%	0.00%	(6.70%)
Other	0.00%	0.70%	1.10%
Effective tax rate	21.50%	14.20%	13.00%

Nature of Business and Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2022

Accounting Policies [Abstract]

Basis of Presentation

The accompanying consolidated financial statements, which have been prepared in accordance with accounting principles generally accepted in the United States of America (“U.S. GAAP”), reflect the operations of Vertex and our wholly-owned subsidiaries. All material intercompany balances and transactions have been eliminated. We operate in one segment, pharmaceuticals. Please refer to Note R, “Segment Information,” for enterprise-wide disclosures regarding our revenues, major customers and long-lived assets by geographic area.

Beginning in 2022, we separately classify upfront, contingent milestone, and other payments pursuant to our business development transactions, including collaborations, licenses of third-party technologies, and asset acquisitions as “Acquired in-process research and development expenses” in our consolidated statements of operations in cases where such acquired assets do not have an alternative future use. To conform prior periods to current presentation, we reclassified $1.1 billion and $184.6 million from “Research and development expenses” to “Acquired in-process research and development expenses” for 2021 and 2020, respectively.

Use of Estimates

The preparation of consolidated financial statements in accordance with U.S. GAAP requires us to make certain estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of our consolidated financial statements, and the amounts of revenues and expenses during the reported periods. We base our estimates on historical experience and various other assumptions, including in certain circumstances future projections that we believe to be reasonable under the circumstances. Actual results could differ from those estimates. Changes in estimates are reflected in reported results in the period in which they become known.

Revenue Recognition

We recognize revenue when a customer obtains control of promised goods or services. We record the amount of revenue that reflects the consideration that we expect to receive in exchange for those goods or services. We apply the following five-step model to determine this amount: (i) identification of the promised goods or services in the contract; (ii) determination of whether the promised goods or services are performance obligations, including whether they are distinct in the context of the contract; (iii) measurement of the transaction price, including the constraint on variable consideration; (iv) allocation of the transaction price to the performance obligations; and (v) recognition of revenue when (or as) we satisfy each performance obligation.

We only apply the five-step model to contracts when it is probable that we will collect the consideration to which we are entitled in exchange for the goods or services that we transfer to the customer. Once a contract is determined to be within the scope of Accounting Standards Codification (“ASC”) 606, Revenue from Contracts with Customers at contract inception, we review the contract to determine which performance obligations we must deliver and which of these performance obligations are distinct. We recognize as revenue the amount of the transaction price that is allocated to each performance obligation

when that performance obligation is satisfied or as it is satisfied. Generally, our performance obligations are transferred to customers at a point in time, typically upon delivery.

Product Revenues, Net

We sell our products principally to a limited number of specialty pharmacy and specialty distributors in the United States (the “U.S.”), which account for the largest portion of our total revenues. We make international sales primarily to specialty distributors and retail pharmacy chains, as well as hospitals and clinics, many of which are government-owned or supported. Our customers in the U.S. subsequently resell the products to patients and health care providers. We recognize net product revenues from sales when our customers obtain control of our products, which typically occurs upon delivery to our customers. Our payment terms are approximately 30 days in the U.S. and consistent with prevailing practice in international markets.

Revenues from product sales are recorded at the net sales price, or “transaction price,” which includes estimates of variable consideration that result from (a) invoice discounts for prompt payment and distribution fees, (b) government and private payor rebates, chargebacks, discounts and fees and (c) costs of co-pay assistance programs for patients, as well as other incentives for certain indirect customers. Reserves are established for the estimates of variable consideration based on the amounts earned or to be claimed on the related sales. The reserves are classified as reductions to “Accounts receivable, net” if payable to a customer or “Accrued expenses” if payable to a third-party. Where appropriate, we utilize the expected value method to determine the appropriate amount for estimates of variable consideration based on factors such as our historical experience, current contractual and statutory requirements, specific known market events and trends, industry data and forecasted customer buying and payment patterns. The amount of variable consideration that is included in the transaction price may be constrained and is included in net product revenues only to the extent that it is probable that a significant reversal in the amount of the cumulative revenue recognized will not occur in a future period. Actual amounts of consideration ultimately received may differ from our estimates. If actual results vary from our estimates, we adjust these estimates, which would affect net product revenue and earnings in the period such variances become known.

Invoice Discounts and Distribution Fees: We generally provide invoice discounts on product sales to our customers for prompt payment and pay fees for distribution services, such as fees for certain data that customers provide to us. We estimate that, based on our experience, our customers will earn these discounts and fees, and deduct the full amount of these discounts and fees from our gross product revenues and accounts receivable at the time such revenues are recognized.

Rebates, Chargebacks, Discounts and Fees: We contract with government agencies (our “Third-party Payors”) so that products will be eligible for purchase by, or partial or full reimbursement from, such Third-party Payors. We estimate the rebates, chargebacks, discounts and fees we will provide to Third-party Payors and deduct these estimated amounts from our gross product revenues at the time the revenues are recognized. For each product, we estimate the aggregate rebates, chargebacks and discounts that we will provide to Third-party Payors based upon (i) our contracts with these Third-party Payors, (ii) the government-mandated discounts and fees applicable to government-funded programs, (iii) information obtained from our customers and other third-party data regarding the payor mix for such product and (iv) historical experience.

Other Incentives: Other incentives that we offer include co-pay mitigation rebates that we provide to commercially insured patients who have coverage and who reside in states that permit co-pay mitigation programs. Based upon the terms of our co-pay mitigation programs, we estimate average co-pay mitigation amounts for each of our products to establish appropriate accruals.

We make significant estimates and judgments that materially affect our recognition of net product revenues. We adjust our estimated rebates, chargebacks and discounts based on new information, including information regarding actual rebates, chargebacks and discounts for our products, as it becomes available. Claims by third-party payors for rebates, chargebacks and discounts frequently are submitted to us significantly after the related sales, potentially resulting in adjustments in the period in which the new information becomes known. Our credits to product revenue related to prior period sales have not been significant and primarily related to rebates and discounts.

We exclude taxes collected from customers relating to product sales and remitted to governmental authorities from revenues.

Contract Liabilities

We had contract liabilities of $159.6 million and $171.7 million as of December 31, 2022 and 2021, respectively, related to annual contracts with government-owned and supported customers in international markets that limit the amount of annual reimbursement we can receive. Upon exceeding the annual reimbursement amount, products are provided free of charge, which is a material right. These contracts include upfront payments and fees. We defer a portion of the consideration received for shipments made up to the annual reimbursement limit as a portion of “Other current liabilities.” The deferred amount is recognized as revenue when the free products are shipped. Our product revenue contracts include performance obligations that are one year or less.

Our contract liabilities at the end of each fiscal year relate to contracts with annual reimbursement limits in international markets in which the annual period associated with the contract is not the same as our fiscal year. In these markets we recognize revenues related to performance obligations satisfied in previous years; however, these revenues do not relate to any performance obligations that were satisfied more than 12 months prior to the beginning of the current year. During the years ended December 31, 2022, 2021 and 2020, we recorded $171.7 million, $191.5 million and $62.3 million, respectively, of revenues that were recorded as contract liabilities at the beginning of the year.

Concentration of Credit Risk

Financial instruments that potentially subject us to concentration of credit risk consist principally of cash equivalents and marketable securities. We place these investments with highly rated financial institutions, and, by policy, limit the amount of credit exposure to any one financial institution. We also maintain a foreign currency hedging program that includes foreign currency forward contracts with several counterparties. We have not experienced any credit losses related to these financial instruments and do not believe we are exposed to any significant credit risk related to these instruments.

We are also subject to credit risk from our accounts receivable related to our product sales and collaborators. We evaluate the creditworthiness of each of our customers and have determined that all our material customers are creditworthy. To date, we have not experienced significant losses with respect to the collection of our accounts receivable. We believe that our allowances, which are not significant to our consolidated financial statements, are adequate at December 31, 2022.

Cash and Cash Equivalents

Cash and Cash EquivalentsWe consider all highly liquid investments with original maturities of three months or less at the date of purchase to be cash equivalents.

Marketable Securities

As of December 31, 2022, our marketable securities consisted of investments in available-for-sale debt securities and corporate equity securities with readily determinable fair values. We classify marketable securities with current maturities of less than one year as current assets on our consolidated balance sheets. The remainder of our marketable securities are classified as long-term assets within “Other assets” on our consolidated balance sheets. The fair value of these securities is based on quoted prices for identical or similar assets.

We record unrealized gains (losses) on available-for-sale debt securities as a component of “Accumulated other comprehensive income,” which is a separate component of shareholders’ equity on our consolidated balance sheets, until such gains and losses are realized. Realized gains and losses, if any, are determined using the specific identification method.

For available-for-sale debt securities in unrealized loss positions, we are required to assess whether to record an allowance for credit losses using an expected loss model. A credit loss is limited to the amount by which the amortized cost of an investment exceeds its fair value. A previously recognized credit loss may be decreased in subsequent periods if our estimate of fair value for the investment increases. To determine whether to record a credit loss, we consider issuer specific credit ratings and historical losses as well as current economic conditions and our expectations for future economic conditions.

We record changes in the fair value of our investments in corporate equity securities to “Other (expense) income, net” in our consolidated statements of operations. Realized gains and losses, which are also included in “Other (expense) income, net,” are determined on an original weighted-average cost basis.

Accounts Receivable

Accounts Receivable We deduct invoice discounts for prompt payment and fees for distribution services from our accounts receivable based on our experience that our customers will earn these discounts and fees. Our estimates for our allowance for credit losses, which has not been significant to date, is determined based on existing contractual payment terms, historical payment patterns, current economic conditions and our expectation for future economic conditions.

Stock-based Compensation Expense

We expense the fair value of employee restricted stock units and other forms of stock-based employee compensation over the associated employee service period on a straight-line basis. Stock-based compensation expense is determined based on the fair value of the award at the grant date and is adjusted each period to reflect actual forfeitures and the outcomes of certain performance conditions.

For awards with performance conditions in which the award does not vest unless the performance condition is met, we recognize expense if, and to the extent that, we estimate that achievement of the performance condition is probable. If we conclude that vesting is probable, we recognize expense from the date we reach this conclusion through the estimated vesting date.

We provide to employees who have rendered a certain number of years of service to Vertex and meet certain age requirements, partial or full acceleration of vesting of these equity awards, subject to certain conditions including a notification period, upon a termination of employment other than for cause. Approximately 5% of our employees were eligible for partial or full acceleration of any of their equity awards as of December 31, 2022. We recognize stock-based compensation expense related to these awards over a service period reflecting qualified employees’ eligibility for partial or full acceleration of vesting.

Research and Development Expenses

Research and development expenses are comprised of costs we incur in performing research and development activities, including salary and benefits; stock-based compensation expense; outsourced services and other direct expenses, including clinical trial and pharmaceutical development costs; intangible asset impairment charges; and infrastructure costs, including facilities costs and depreciation expense. We recognize research and development expenses as incurred. We capitalize nonrefundable advance payments we make for research and development activities and expense the payments as the related goods are delivered or the related services are performed.

Acquired In-process Research and Development Expenses

Our research and development activities include upfront, contingent milestone, and other payments pursuant to our business development transactions, including collaborations, licenses of third-party technologies, and asset acquisitions. In-process research and development that is acquired in a transaction that does not qualify as a business combination under U.S. GAAP and that does not have an alternative future use is recorded to “Acquired in-process research and development expenses” in our consolidated statements of operations in the period in which it is acquired.

Inventories

We value our inventories at the lower-of-cost or net realizable value. We determine the cost of our inventories, which include amounts related to materials and manufacturing overhead, on a first-in, first-out basis. We perform an assessment of the recoverability of our capitalized inventory during each reporting period and write down any excess and obsolete inventories to their net realizable value in the period in which the impairment is first identified. Shipping and handling costs incurred for inventory purchases are capitalized and recorded upon sale in “Cost of sales” in our consolidated statements of operations. Shipping and handling costs incurred for product shipments are recorded as incurred in “Cost of sales” in our consolidated statements of operations.

We capitalize inventories produced in preparation for initiating sales of a product candidate when the related product candidate is considered to have a high likelihood of regulatory approval and the related costs are expected to be recoverable through sales of the inventories. In determining whether to capitalize such inventories, we evaluate, among other factors, information regarding the product candidate’s safety and efficacy, the status of regulatory submissions and communications with regulatory authorities and the outlook for commercial sales, including the existence of current or anticipated competitive drugs and the availability of reimbursement. In addition, we evaluate risks associated with manufacturing the product candidate and the remaining shelf-life of the inventories.

Property and Equipment

Property and equipment are recorded at cost, net of accumulated depreciation. Depreciation expense is recorded using the straight-line method over the estimated useful life of the related asset generally as follows:


Description						Estimated Useful Life
Buildings and improvements						15 to 40 years
Laboratory equipment, other equipment and furniture						7 to 10 years
Leasehold improvements; assets under finance leases						The shorter of the useful life of the assets or the estimated remaining term of the associated lease
Computers and software						3 to 5 years

Maintenance and repairs to an asset that do not improve or extend its life are charged to operations. When assets are retired or otherwise disposed of, the assets and related accumulated depreciation are eliminated from the accounts and any resulting gain or loss is reflected in our consolidated statements of operations. We perform an assessment of the fair value of the assets if indicators of impairment are identified during a reporting period and record the assets at the lower of the net book value or the fair value of the assets.

We capitalize costs incurred to develop software for internal use during the application development stage. Amortization of capitalized internally developed software costs is recorded in depreciation expense over the useful life of the related asset.

Cloud Computing Service Contracts

We classify costs incurred to implement cloud computing service contracts as “Other assets” on our consolidated balance sheets. Amortization is recorded over the noncancellable term of the cloud computing service contract, plus any optional renewal periods that are reasonably certain to be exercised.

Leases

We determine whether an arrangement contains a lease at inception. If a lease is identified in an arrangement, we recognize a right-of-use asset and liability on our consolidated balance sheet and determine whether the lease should be classified as a finance or operating lease. We do not recognize assets or liabilities for leases with lease terms of less than 12 months.

A lease qualifies as a finance lease if any of the following criteria are met at the inception of the lease: (i) there is a transfer of ownership of the leased asset to Vertex by the end of the lease term, (ii) we hold an option to purchase the leased asset that we are reasonably certain to exercise, (iii) the lease term is for a major part of the remaining economic life of the leased asset, (iv) the present value of the sum of lease payments equals or exceeds substantially all of the fair value of the leased asset, or (v) the nature of the leased asset is specialized to the point that it is expected to provide the lessor no alternative use at the end of the lease term. All other leases are recorded as operating leases.

Finance and operating lease assets and liabilities are recognized at the lease commencement date based on the present value of the lease payments over the lease term using the discount rate implicit in the lease. If the rate implicit is not readily determinable, we utilize our incremental borrowing rate at the lease commencement date. Operating lease assets are further adjusted for prepaid or accrued lease payments. Operating lease payments are expensed using the straight-line method as an operating expense over the lease term. Finance lease assets are amortized to depreciation expense using the straight-line method over the shorter of the useful life of the related asset or the lease term. Finance lease payments are bifurcated into (i) a portion that is recorded as imputed interest expense and (ii) a portion that reduces the finance liability associated with the lease.

We do not separate lease and non-lease components for our real estate leases when determining which lease payments to include in the calculation of our lease assets and liabilities. Variable lease payments are expensed as incurred. If a lease includes an option to extend or terminate the lease, we reflect the option in the lease term if it is reasonably certain we will exercise the option.

Finance leases are recorded in “Property and equipment, net,” “Other current liabilities” and “Long-term finance lease liabilities,” and operating leases are recorded in “Operating lease assets,” “Other current liabilities” and “Long-term operating lease liabilities” on our consolidated balance sheets.

Income Taxes

Our provision for income taxes is accounted for under the asset and liability method and includes federal, state, local and foreign taxes.

Deferred tax assets and liabilities are recognized for the estimated future tax consequences of temporary differences between the financial statement carrying amounts and the income tax bases of assets and liabilities. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the year in which the temporary differences are expected to be recovered or settled. A valuation allowance is applied against any net deferred tax asset if, based on the available evidence, it is more likely than not that some or all of the deferred tax assets will not be realized. On a periodic basis, we reassess the valuation allowance on our deferred income tax assets weighing positive and negative evidence to assess the recoverability of our deferred tax assets. We include, among other things, our recent financial performance and our future projections in this periodic assessment.

We record liabilities related to uncertain tax positions by prescribing a minimum recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. We evaluate our uncertain tax positions on a quarterly basis and consider various factors, including, but not limited to, changes in tax law, the measurement of tax positions taken or expected to be taken in our tax returns, and changes in facts or circumstances related to a tax position. We adjust our liabilities to reflect any subsequent changes in the relevant facts and circumstances surrounding the uncertain positions. We accrue interest and penalties related to unrecognized tax benefits as a component of our “Provision for income taxes.”

As part of the U.S. Tax Cut and Jobs Act of 2017, we are subject to a territorial tax system, under which we must

establish an accounting policy to provide for tax on Global Intangible Low Taxed Income (“GILTI”) earned by certain foreign subsidiaries. We have elected to treat the impact of GILTI as a current tax expense in our “Provision for income taxes.”

Variable Interest Entities

We review each agreement pursuant to which we license technologies owned by a third party to determine whether or not we have a variable interest via the license agreement with the third party and if the variable interest is a variable interest in the third party as a whole and whether or not we are the primary beneficiary of that variable interest entity (“VIE”). If we determine we are the primary beneficiary of a VIE at the onset of a license agreement, it is treated as a business combination and we consolidate the financial statements of the VIE into our consolidated financial statements until we are no longer the primary beneficiary of the consolidated VIE, or no longer have a variable interest in the VIE. As of December 31, 2022 and 2021, we did not have any consolidated VIEs.

Fair Value of In-process Research and Development Assets and Contingent Payments

The present-value models we use to estimate the fair values of in-process research and development assets and contingent payments pursuant to third-party license agreements and acquisitions incorporate significant assumptions.

The fair value of our in-process research and development assets is determined using either the multi-period excess earnings or the relief from royalty methods of the income approach. Each method requires us to make: (i) assumptions regarding the probability of obtaining marketing approval for a product candidate; (ii) estimates of future cash flows from potential product sales with respect to a product candidate; and (iii) appropriate discount and tax rates. The multi-period excess earnings method also requires us to estimate the timing of and the expected costs to develop and commercialize a product candidate. The relief from royalty method also requires us to estimate the after-tax royalty savings expected from ownership of a product candidate that we acquired.

We base our estimates of the probability of achieving the milestones relevant to the fair value of contingent payments, which could include milestone, royalty and option payments, on industry data attributable to rare diseases and our knowledge of the programs and viability of the programs. Estimates included in the discounted cash flow models pertaining to contingent payments also include: (i) estimate regarding the timing of the relevant development and commercial milestones and royalties, (ii) and appropriate discount rates. We record any increases or decreases in the fair value of our contingent payments to “Change in fair value of contingent consideration” in our consolidated statements of operations.

In-process Research and Development Assets

We record the fair value of in-process research and development assets as of the transaction date of a business combination. Each of these assets is accounted for as an indefinite-lived intangible asset and is maintained on our consolidated balance sheets until either the underlying project is completed or the asset becomes impaired. If the asset becomes impaired or is abandoned, the carrying value of the related intangible asset is written down to its fair value, and an impairment charge is recorded in the period in which the impairment occurs. If a project is completed, the carrying value of the related intangible asset is amortized as a part of “Cost of sales” over the remaining estimated life of the asset beginning in the period in which the project is completed. In-process research and development assets are tested for impairment on an annual basis as of October 1, and more frequently if indicators are present or changes in circumstances suggest that impairment may exist.

Goodwill

GoodwillThe difference between the purchase price and the fair value of assets acquired and liabilities assumed in a business combination is allocated to goodwill. Goodwill is evaluated for impairment on an annual basis as of October 1, and more frequently if indicators are present or changes in circumstances suggest that impairment may exist.

Hedging Activities

We recognize the fair value of hedging instruments that are designated and qualify as hedging instruments pursuant to U.S. GAAP, foreign currency forward contracts, as either assets or liabilities on our consolidated balance sheets. Changes in the fair value of these instruments are recorded each period in “Accumulated other comprehensive income” as unrealized gains and losses until the forecasted underlying transaction occurs. Unrealized gains and losses on these foreign currency forward contracts are included in “Prepaid expenses and other current assets” or “Other assets,” and “Other current liabilities” or “Other long-term liabilities,” respectively, on our consolidated balance sheets depending on the remaining period until their contractual maturity. Realized gains and losses for the effective portion of such contracts are recognized in “Product revenues, net” in our consolidated statement of operations in the same period that we recognize the product revenues that were impacted by the hedged foreign exchange rate changes. We classify the cash flows from hedging instruments in the same category as the cash flows from the hedged items.

Certain of our hedging instruments are subject to master netting arrangements to reduce the risk arising from such transactions with our counterparties. We present unrealized gains and losses on our foreign currency forward contracts on a gross basis within our consolidated balance sheets.

We also enter into foreign currency forward contracts with contractual maturities of less than one month designed to mitigate the effect of changes in foreign exchange rates on monetary assets and liabilities including intercompany balances. These contracts are not designated as hedging instruments pursuant to U.S. GAAP. Realized gains and losses for such contracts are recognized in “Other (expense) income, net” in our consolidated statements of operations each period.

Comprehensive Income

Comprehensive income consists of net income and other comprehensive income (loss), which includes foreign currency translation adjustments and unrealized gains and losses on foreign currency forward contracts and our available-for-sale debt securities. For purposes of comprehensive income disclosures, we record provisions for or benefits from income taxes related to the unrealized gains and losses on foreign currency forward contracts and our available-for-sale debt securities. We do not record provisions for or benefits from income taxes related to our cumulative translation adjustment, as we intend to permanently reinvest undistributed earnings in our foreign subsidiaries.

Foreign Currency Translation and Transactions

Foreign Currency Translation and TransactionsThe majority of our operations occur in entities that have the U.S. dollar denominated as their functional currency. The assets and liabilities of our entities with functional currencies other than the U.S. dollar are translated into U.S. dollars at exchange rates in effect at the end of the year. Revenue and expense amounts for these entities are translated using the average exchange rates for the period. Changes resulting from foreign currency translation are included in “Accumulated other comprehensive income.”

Share Repurchase Programs

Repurchases of our common stock are recorded as reductions to “Common Stock” and “Additional paid-in capital” pursuant to our established accounting policy. Repurchases in excess of the par value will be recorded as reductions to “Retained earnings” in the event that “Additional paid-in capital” is reduced to zero.

Net Income Per Common Share

Basic net income per common share is based upon the weighted-average number of common shares outstanding during the period. Diluted net income per common share utilizing the treasury-stock method is based upon the weighted-average number of common shares outstanding during the period plus additional weighted-average common equivalent shares outstanding during the period when the effect is dilutive. Potentially dilutive shares result from the assumed exercise of outstanding stock options and assumed vesting of restricted stock units (including performance-based restricted stock units) (the proceeds of which are then assumed to have been used to repurchase outstanding stock using the treasury-stock method).

Recently Adopted and Issued Accounting Standards

We have not been required to adopt any accounting standards that had a significant impact on our consolidated financial statements in the three years ended December 31, 2022. We do not expect any recently issued accounting standards to have a significant impact on our consolidated financial statements.

Accumulated Other Comprehensive Income (Loss) (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Beginning balance	$ 10,100.0	$ 8,686.8	$ 6,085.2
Other comprehensive (loss) income before reclassifications	124.2	60.9	(69.4)
Amounts reclassified from accumulated other comprehensive income (loss)	(139.3)	23.5	2.9
Total other comprehensive (loss) income	(15.1)	84.4	(66.5)
Ending balance	13,912.7	10,100.0	8,686.8
Foreign Currency Translation Adjustment
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Beginning balance	(13.6)	(15.6)	(0.9)
Other comprehensive (loss) income before reclassifications	(11.4)	2.0	(14.7)
Amounts reclassified from accumulated other comprehensive income (loss)	0.0	0.0	0.0
Total other comprehensive (loss) income	(11.4)	2.0	(14.7)
Ending balance	(25.0)	(13.6)	(15.6)
On Available-For-Sale Debt Securities
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Beginning balance	(0.5)	0.3	0.5
Other comprehensive (loss) income before reclassifications	(3.3)	(0.8)	(0.2)
Amounts reclassified from accumulated other comprehensive income (loss)	3.7	0.0	0.0
Total other comprehensive (loss) income	0.4	(0.8)	(0.2)
Ending balance	(0.1)	(0.5)	0.3
On Foreign Currency Forward Contracts
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Beginning balance	30.0	(53.2)	(1.6)
Other comprehensive (loss) income before reclassifications	138.9	59.7	(54.5)
Amounts reclassified from accumulated other comprehensive income (loss)	(143.0)	23.5	2.9
Total other comprehensive (loss) income	(4.1)	83.2	(51.6)
Ending balance	25.9	30.0	(53.2)
Total
AOCI Attributable to Parent, Net of Tax [Roll Forward]
Beginning balance	15.9	(68.5)	(2.0)
Total other comprehensive (loss) income	(15.1)	84.4	(66.5)
Ending balance	$ 0.8	$ 15.9	$ (68.5)

- Definition

Total of all stockholders' equity (deficit) items, net of receivables from officers, directors, owners, and affiliates of the entity which are attributable to the parent. The amount of the economic entity's stockholders' equity attributable to the parent excludes the amount of stockholders' equity which is allocable to that ownership interest in subsidiary equity which is not attributable to the parent (noncontrolling interest, minority interest). This excludes temporary equity and is sometimes called permanent equity.

+ References

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 235
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(g)(1)(ii))
-URI https://asc.fasb.org/extlink&oid=120395691&loc=d3e23780-122690

Reference 2: http://www.xbrl.org/2003/role/exampleRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 852
-SubTopic 10
-Section 55
-Paragraph 10
-URI https://asc.fasb.org/extlink&oid=84165509&loc=d3e56426-112766

Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 310
-SubTopic 10
-Section S99
-Paragraph 2
-Subparagraph (SAB Topic 4.E)
-URI https://asc.fasb.org/extlink&oid=122038336&loc=d3e74512-122707

Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 210
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.5-02(31))
-URI https://asc.fasb.org/extlink&oid=120391452&loc=d3e13212-122682

Reference 5: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 210
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.5-02(29))
-URI https://asc.fasb.org/extlink&oid=120391452&loc=d3e13212-122682

Reference 6: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 210
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.5-02(30))
-URI https://asc.fasb.org/extlink&oid=120391452&loc=d3e13212-122682

Reference 7: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 825
-SubTopic 10
-Section 50
-Paragraph 28
-Subparagraph (f)
-URI https://asc.fasb.org/extlink&oid=123596393&loc=d3e14064-108612

Reference 8: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 323
-SubTopic 10
-Section 50
-Paragraph 3
-Subparagraph (c)
-URI https://asc.fasb.org/extlink&oid=114001798&loc=d3e33918-111571

+ Details

Segment Information - Revenue by Geographic Location (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Revenues from External Customers and Long-Lived Assets [Line Items]
Total product revenues, net	$ 8,930.7	$ 7,574.4	$ 6,205.7
Product revenues, net
Revenues from External Customers and Long-Lived Assets [Line Items]
Total product revenues, net	8,930.7	7,573.4	6,202.8
United States \| Product revenues, net
Revenues from External Customers and Long-Lived Assets [Line Items]
Total product revenues, net	5,699.3	5,287.3	4,826.4
Europe \| Product revenues, net
Revenues from External Customers and Long-Lived Assets [Line Items]
Total product revenues, net	2,705.5	1,972.9	1,126.5
Other \| Product revenues, net
Revenues from External Customers and Long-Lived Assets [Line Items]
Total product revenues, net	525.9	313.2	249.9
Total product revenues outside of the United States \| Product revenues, net
Revenues from External Customers and Long-Lived Assets [Line Items]
Total product revenues, net	$ 3,231.4	$ 2,286.1	$ 1,376.4

- Definition

Amount, excluding tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value added and excise.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 30
-Subparagraph (a)
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8906-108599

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 40
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e9031-108599

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 41
-Subparagraph (a)
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e9038-108599

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (b)
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8933-108599

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (a)
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8933-108599

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 4
-Subparagraph (a)
-URI https://asc.fasb.org/extlink&oid=126920106&loc=SL49130543-203045

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 22
-Subparagraph (b)
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8736-108599

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 22
-Subparagraph (a)
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8736-108599

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 42
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e9054-108599

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 5
-URI https://asc.fasb.org/extlink&oid=126920106&loc=SL49130545-203045

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 924
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SAB Topic 11.L)
-URI https://asc.fasb.org/extlink&oid=6472922&loc=d3e499488-122856

+ Details

Additional Balance Sheet Detail - Summary of Other Long Term Liabilities (Details) - USD ($) $ in Millions	Dec. 31, 2022	Dec. 31, 2021
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]
Tax related liabilities	$ 452.8	$ 0.0
Contingent consideration	114.4	186.5
Other	118.6	116.8
Total	$ 685.8	$ 303.3

Fair Value Measurements

12 Months Ended

Dec. 31, 2022

Fair Value Disclosures [Abstract]

Fair Value Measurements

The following fair value hierarchy is used to classify assets and liabilities based on observable inputs and unobservable inputs used to determine the fair value of our financial assets and liabilities:


Level 1:			Quoted prices in active markets for identical assets or liabilities. An active market for an asset or liability is a market in which transactions for the asset or liability occur with sufficient frequency and volume to provide pricing information on an ongoing basis.
Level 2:			Observable inputs other than Level 1 inputs. Examples of Level 2 inputs include quoted prices in active markets for similar assets or liabilities and quoted prices for identical assets or liabilities in markets that are not active.
Level 3:			Unobservable inputs based on our assessment of the assumptions that market participants would use in pricing the asset or liability.

Our investment strategy is focused on capital preservation. We invest in instruments that meet the credit quality standards outlined in our investment policy, which also limits the amount of credit exposure to any one issue or type of instrument. We maintain strategic investments separately from the investment policy that governs our other cash, cash

equivalents and marketable securities as described in Note F, “Marketable Securities and Equity Investments.” Additionally, we utilize foreign currency forward contracts intended to mitigate the effect of changes in foreign exchange rates on our consolidated statements of operations.

The following tables set forth our financial assets and liabilities subject to fair value measurements by level within the fair value hierarchy (and does not include $3.1 billion and $3.3 billion of cash as of December 31, 2022 and 2021, respectively):


	As of December 31, 2022								As of December 31, 2021
			Fair Value Hierarchy								Fair Value Hierarchy
	Total		Level 1		Level 2		Level 3		Total		Level 1		Level 2		Level 3
	(in millions)
Financial instruments carried at fair value (asset positions):
Cash equivalents:
Money market funds	$	5,162.6	$	5,162.6	$	—	$	—	$	3,478.1	$	3,478.1	$	—	$	—
Time deposits	2,000.0		—		2,000.0		—		—		—		—		—
Corporate debt securities	5.8		—		5.8		—		—		—		—		—
Commercial paper	204.5		—		204.5		—		—		—		—		—
Marketable securities:
Corporate equity securities	116.8		88.8		28.0		—		230.9		230.9		—		—
U.S. Treasury securities	—		—		—		—		86.4		86.4		—		—
Government-sponsored enterprise securities	127.1		127.1		—		—		69.0		69.0		—		—
Corporate debt securities	87.0		—		87.0		—		90.9		—		90.9		—
Commercial paper	55.8		—		55.8		—		252.7		—		252.7		—
Prepaid expenses and other current assets:
Foreign currency forward contracts	47.5		—		47.5		—		44.5		—		44.5		—
Other assets:
Foreign currency forward contracts	0.8		—		0.8		—		2.0		—		2.0		—
Total financial assets	$	7,807.9	$	5,378.5	$	2,429.4	$	—	$	4,254.5	$	3,864.4	$	390.1	$	—

Financial instruments carried at fair value (liability positions):
Other current liabilities:
Foreign currency forward contracts	$	(14.3)	$	—	$	(14.3)	$	—	$	(5.6)	$	—	$	(5.6)	$	—
Contingent consideration	(14.6)		—		—		(14.6)		—		—		—		—
Other long-term liabilities:
Foreign currency forward contracts	(0.9)		—		(0.9)		—		(2.7)		—		(2.7)		—
Contingent consideration	(114.4)		—		—		(114.4)		(186.5)		—		—		(186.5)
Total financial liabilities	$	(144.2)	$	—	$	(15.2)	$	(129.0)	$	(194.8)	$	—	$	(8.3)	$	(186.5)

Please refer to Note F, “Marketable Securities and Equity Investments,” for the carrying amount and related unrealized gains (losses) by type of investment.

Fair Value of Corporate Equity Securities

We classify our investments in publicly traded corporate equity securities as “Marketable securities” on our consolidated balance sheets. Generally, our investments in the common stock of publicly traded companies are valued based on Level 1 inputs because they have readily determinable fair values. However, certain of our investments in publicly traded companies have been or continue to be valued based on Level 2 inputs due to transfer restrictions associated with these investments. Please refer to Note F, “Marketable Securities and Equity Investments,” for further information on these investments.

Fair Value of Contingent Consideration

In 2019, we acquired Exonics Therapeutics, Inc. (“Exonics”), a privately held company focused on creating

transformative gene-editing therapies to repair mutations that cause Duchenne muscular dystrophy and other severe neuromuscular diseases, including DM1. Our Level 3 contingent consideration liabilities are related to $678.3 million of development and regulatory milestones potentially payable to former Exonics equity holders. We base our estimates of the probability of achieving the milestones relevant to the fair value of contingent payments, which could include milestone, royalty and option payments, on industry data attributable to rare diseases and our knowledge of the programs and viability of the programs. The discount rates used in the valuation model for contingent payments, which were between 5.1% and 6.0% as of December 31, 2022, represent a measure of credit risk and market risk associated with settling the liabilities. Significant judgment is used in determining the appropriateness of these assumptions at each reporting period. Due to the uncertainties associated with development and commercialization of product candidates in the pharmaceutical industry and the effects of changes in other assumptions including discount rates, we expect our estimates regarding the fair value of contingent consideration to change in the future, resulting in adjustments to the fair value of our contingent consideration liabilities, and the effect of any such adjustments could be material.

The following table represents a rollforward of the fair value of our contingent consideration liabilities:


	Year Ended December 31, 2022
	(in millions)
Balance at December 31, 2021	$	186.5
Decrease in fair value of contingent payments	(57.5)
Balance at December 31, 2022	$	129.0

The decrease in fair value of contingent consideration during 2022 was primarily due to a revision to the scope of certain acquired gene-editing programs in the second quarter of 2022.

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References + Details

Hedging - Additional Information (Details) - Foreign currency forward contracts $ in Billions	12 Months Ended
	Dec. 31, 2022 USD ($)
Not designated as hedging instrument
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Derivative term	1 month
Cash Flow Hedging \| Not designated as hedging instrument
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Notional amount of foreign currency forward contract	$ 1.0
Cash Flow Hedging \| Minimum
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Derivative term	1 month
Cash Flow Hedging \| Maximum
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Derivative term	18 months

Nature of Business and Accounting Policies - Goodwill Hedging Activities Foreign Currency Gain (Loss) (Details) $ in Millions	12 Months Ended
	Dec. 31, 2022 USD ($) segment	Dec. 31, 2021 USD ($)	Dec. 31, 2020 USD ($)
Derivative [Line Items]
Number of operating segments \| segment	1
Net foreign currency transaction loss \| $	$ 15.1	$ 13.9	$ 16.1
Foreign currency forward contracts \| Not designated as hedging instrument
Derivative [Line Items]
Derivative term	1 month

Income Taxes - Additional Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Tax Carryforwards [Line Items]
Effective tax rate	21.50%	14.20%	13.00%
Discrete tax benefit associated with tax credit research		$ 44.1
Discrete tax benefit associated with an intra-entity transfer of intellectual property rights			$ 209.0
Valuation allowance	$ 237.8	220.4
Deferred costs	195.1	225.4
Increase in unrecognized tax benefits	312.4
Unrecognized tax benefits, reduction in deferred tax assets, gross	29.7
Unrecognized tax benefits, deferred tax liabilities, gross	282.7
Unrecognized tax benefits	459.6	147.2	86.6	$ 33.9
Net unrecognized tax benefits which would affect the tax rate if recognized	208.5	129.5	75.8
Unrecognized tax benefits, income tax penalties and interest expense	36.6	0.0	$ 0.0
Unrecognized tax benefits, income tax penalties and interest accrued	39.2	0.0
Decrease in unrecognized tax benefits is reasonably possible	9.1
Deferred Tax Assets
Tax Carryforwards [Line Items]
Unrecognized tax benefits	44.1
Other long-term liabilities
Tax Carryforwards [Line Items]
Unrecognized tax benefits	415.5
Domestic Tax Authority
Tax Carryforwards [Line Items]
Operating loss carryforwards	65.3
Operating loss carryforwards, subject to expiration	19.8
State and Local Jurisdiction
Tax Carryforwards [Line Items]
Operating loss carryforwards	553.8
Tax credit carryforwards	273.5
Foreign Tax Authority
Tax Carryforwards [Line Items]
Discrete tax benefit associated with an increase in U.K.'s corporate tax rate		$ 94.8
Operating loss carryforwards	151.4
Tax credit carryforwards	21.5
Operating loss carryforwards, subject to expiration	$ 70.0

Marketable Securities and Equity Investments - Summary of Cash Equivalents and Marketable Securities (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021
Cash equivalents:
Amortized Cost	$ 7,372.9	$ 3,478.1
Fair Value	7,372.9	3,478.1
Total marketable debt securities
Fair Value	5,642.8	3,977.1
Corporate equity securities
Amortized Cost	104.4	69.4
Gross Unrealized Gains	30.9	167.1
Gross Unrealized Losses	(18.5)	(5.6)
Fair Value	116.8	230.9
Amortized Cost	374.4	568.9
Gross Unrealized Gains	31.1	167.1
Gross Unrealized Losses	(18.8)	(6.1)
Fair Value	386.7	729.9
Marketable securities and other assets
Total marketable debt securities
Amortized Cost	270.0	499.5
Gross Unrealized Gains	0.2	0.0
Gross Unrealized Losses	(0.3)	(0.5)
Fair Value	269.9	499.0
Money market funds
Cash equivalents:
Amortized Cost	5,162.6	3,478.1
Fair Value	5,162.6	3,478.1
Time deposits
Cash equivalents:
Amortized Cost	2,000.0	0.0
Fair Value	2,000.0	0.0
Corporate debt securities
Cash equivalents:
Amortized Cost	5.8	0.0
Fair Value	5.8	0.0
Total marketable debt securities
Amortized Cost	87.2	91.1
Gross Unrealized Gains	0.0	0.0
Gross Unrealized Losses	(0.2)	(0.2)
Fair Value	87.0	90.9
Commercial paper
Cash equivalents:
Amortized Cost	204.5	0.0
Fair Value	204.5	0.0
U.S. Treasury securities
Total marketable debt securities
Amortized Cost	0.0	86.6
Gross Unrealized Gains	0.0	0.0
Gross Unrealized Losses	0.0	(0.2)
Fair Value	0.0	86.4
Government-sponsored enterprise securities
Total marketable debt securities
Amortized Cost	127.0	69.0
Gross Unrealized Gains	0.2	0.0
Gross Unrealized Losses	(0.1)	0.0
Fair Value	127.1	69.0
Commercial paper
Total marketable debt securities
Amortized Cost	55.8	252.8
Gross Unrealized Gains	0.0	0.0
Gross Unrealized Losses	0.0	(0.1)
Fair Value	$ 55.8	$ 252.7

Business Combination

12 Months Ended

Dec. 31, 2022

Business Combination and Asset Acquisition [Abstract]

Business Combination

On September 27, 2022, we acquired all outstanding shares of ViaCyte, Inc. (“ViaCyte”), a privately held biotechnology company primarily focused on delivering novel stem cell-derived cell replacement therapies as a functional cure for type 1 diabetes, in exchange for $315.0 million. ViaCyte’s intellectual property and assembled workforce complement our ongoing programs and have the potential to produce therapies for patients with type 1 diabetes. We accounted for the transaction as a business combination, and allocated the purchase price to the following assets acquired and liabilities assumed:


	As of September 27, 2022
	(in millions)
Cash and cash equivalents	$	19.1
Goodwill	85.8
Intangible asset	216.6
Net other liabilities	(6.5)
Total purchase price	$	315.0

The “Goodwill” represents the difference between the fair value of the consideration transferred and the fair value of the assets acquired and liabilities assumed. The goodwill is attributable to (i) the technological expertise in cell therapy of ViaCyte’s assembled workforce, (ii) the potential synergies from combining ViaCyte’s technology with our clinical development capabilities and (iii) the potential future benefits for other therapeutic programs that the acquired technology could be used for, but did not meet the definition of an in-process research and development asset. None of the goodwill is expected to be deductible for income tax purposes.

The “Intangible asset” is an in-process research and development asset of $216.6 million related to ViaCyte’s technology and intellectual property associated with stem cell differentiation and manufacturing. The fair value of the intangible asset was determined through a discounted cash flow analysis using the relief from royalty method, which estimated the cost savings associated with owning an asset instead of paying a royalty to the previous owner. The relief from royalty method utilized Level 3 fair value inputs including (i) estimated future product sales, which were calculated using, among other assumptions, an estimated probability of obtaining marketing approval for the asset, (ii) estimated after-tax royalty savings expected from ownership of the asset, and (iii) an appropriate discount and tax rate.

Our analysis of the fair value of certain assets acquired, including certain tax analyses, related to the ViaCyte business combination was preliminary as of September 30, 2022. In the fourth quarter of 2022, we recorded immaterial measurement period adjustments to goodwill and finalized our analysis of the fair value of assets acquired and liabilities assumed. In 2022, the financial results of ViaCyte did not have a material effect on our consolidated statement of operations.

Additional Balance Sheet Detail - Additional Information (Details) - USD ($) $ in Millions	Dec. 31, 2022	Dec. 31, 2021
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]
Cloud computing service contracts	$ 40.2	$ 0.0

Stock-based Compensation Expense - Additional Information (Details)	12 Months Ended
	Dec. 31, 2022 USD ($) installment $ / shares	Dec. 31, 2021 USD ($) $ / shares	Dec. 31, 2020 USD ($) $ / shares
Stock options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Weighted-average grant-date fair value, granted ( in usd per share) \| $ / shares	$ 89.65	$ 65.94	$ 88.37
Expected annual dividends \| $	$ 0	$ 0	$ 0
Financial performance shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of installments \| installment	3
Vesting period	3 years
Financial performance shares \| Tranche one
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting percentage	33.30%
Financial performance shares \| Tranche two
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting percentage	33.30%
Financial performance shares \| Tranche three
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting percentage	33.30%
Non-financial performance shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period	3 years
ESPP share issuances
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected annual dividends \| $	$ 0	$ 0	$ 0
Granted (in dollars per share) \| $ / shares	$ 79.36	$ 51.71	$ 65.88

Marketable Securities and Equity Investments - Additional Information (Details) - USD ($)	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Summary of cash, cash equivalents and marketable securities
Cash	$ 3,100,000,000	$ 3,300,000,000
Allowance for credit loss for available-for-sale debt securities	0	0	$ 0
Debt securities, available-for-sale, realized gain (loss)	0	0	0
Net unrealized (losses) gains	(149,100,000)	17,100,000	136,200,000
Weighted-average cost basis	104,400,000	69,400,000
Other assets
Summary of cash, cash equivalents and marketable securities
Equity securities without readily determinable fair value, amount	98,600,000
Publicly Traded Companies Sale
Summary of cash, cash equivalents and marketable securities
Proceeds received	$ 0	$ 0	437,600,000
Weighted-average cost basis			$ 103,300,000

Marketable Securities and Equity Investments - Available-for-Sale Debt Securities at Fair Value (Details) - USD ($) $ in Millions	Dec. 31, 2022	Dec. 31, 2021
Debt Securities, Available-for-sale [Line Items]
Debt Securities	$ 5,642.8	$ 3,977.1
Cash and cash equivalents
Debt Securities, Available-for-sale [Line Items]
Debt Securities	5,372.9	3,478.1
Marketable securities
Debt Securities, Available-for-sale [Line Items]
Debt Securities	157.7	499.0
Other assets
Debt Securities, Available-for-sale [Line Items]
Debt Securities	$ 112.2	$ 0.0

Common Stock, Preferred Stock and Equity Plans - Employee Stock Purchase Plan (Details) - ESPP share issuances	12 Months Ended
	Dec. 31, 2022 period $ / shares shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Offering period (in months)	12 months
Number of purchase periods \| period	2
Duration of purchase period	6 months
Eligible employee purchase price percentage of fair value	85.00%
Number of shares authorized (in shares)	1,500,000
Number of shares (in shares)	261,000
Average price paid per share (in dollars per share) \| $ / shares	$ 161.74

Intangible Assets and Goodwill (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2022	Sep. 27, 2022	Dec. 31, 2021
Indefinite-Lived Intangible Assets [Line Items]
Intangible assets	$ 603.6		$ 400.0
Goodwill	$ 1,088.0		$ 1,002.2
Impairment, Intangible Asset, Indefinite-Lived (Excluding Goodwill), Statement of Income or Comprehensive Income [Extensible Enumeration]	Research and Development Expense (Excluding Acquired in Process Cost)
In Process Research and Development
Indefinite-Lived Intangible Assets [Line Items]
Intangible asset impairment charges	$ 13.0
ViaCyte
Indefinite-Lived Intangible Assets [Line Items]
Goodwill	85.8	$ 85.8
ViaCyte \| In Process Research and Development
Indefinite-Lived Intangible Assets [Line Items]
Indefinite-lived intangible assets acquired	$ 216.6

- Definition

Amount after accumulated impairment loss of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

+ References + Details

Marketable Securities and Equity Investments

12 Months Ended

Dec. 31, 2022

Investments, Debt and Equity Securities [Abstract]

Marketable Securities and Equity Investments

A summary of our cash equivalents and marketable securities, which are recorded at fair value (and do not include $3.1 billion and $3.3 billion of cash as of December 31, 2022 and 2021, respectively), is shown below:


	As of December 31, 2022								As of December 31, 2021
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Fair Value		Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Fair Value
	(in millions)
Cash equivalents:
Money market funds	$	5,162.6	$	—	$	—	$	5,162.6	$	3,478.1	$	—	$	—	$	3,478.1
Time deposits	2,000.0		—		—		2,000.0		—		—		—		—
Corporate debt securities	5.8		—		—		5.8		—		—		—		—
Commercial paper	204.5		—		—		204.5		—		—		—		—
Total cash equivalents	$	7,372.9	$	—	$	—	$	7,372.9	$	3,478.1	$	—	$	—	$	3,478.1
Marketable securities:
U.S. Treasury securities	$	—	$	—	$	—	$	—	$	86.6	$	—	$	(0.2)	$	86.4
Government-sponsored enterprise securities	127.0		0.2		(0.1)		127.1		69.0		—		—		69.0
Corporate debt securities	87.2		—		(0.2)		87.0		91.1		—		(0.2)		90.9
Commercial paper	55.8		—		—		55.8		252.8		—		(0.1)		252.7
Total marketable debt securities	270.0		0.2		(0.3)		269.9		499.5		—		(0.5)		499.0
Corporate equity securities	104.4		30.9		(18.5)		116.8		69.4		167.1		(5.6)		230.9
Total marketable securities	$	374.4	$	31.1	$	(18.8)	$	386.7	$	568.9	$	167.1	$	(6.1)	$	729.9

Available-for-sale debt securities were classified on our consolidated balance sheets at fair value as follows:


	December 31,
	2022		2021
	(in millions)
Cash and cash equivalents	$	5,372.9	$	3,478.1
Marketable securities	157.7		499.0
Other assets	112.2		—
Total	$	5,642.8	$	3,977.1

Available-for-sale debt securities by contractual maturity were as follows:


	December 31,
	2022		2021
	(in millions)
Matures within one year	$	5,530.6	$	3,912.3
Matures after one year through five years	112.2		64.8
Total	$	5,642.8	$	3,977.1

We did not record any allowances for credit losses to adjust the fair value of available-for-sale debt securities in 2022, 2021 or 2020. Additionally, we did not record any realized gains or losses that were material to our consolidated statements of operations in 2022, 2021 or 2020.

We record changes in the fair value of our investments in corporate equity securities to “Other (expense) income, net” in our consolidated statements of operations. During the three years ended December 31, 2022, our net unrealized (losses) gains on corporate equity securities held at the conclusion of each period were as follows:


	2022		2021		2020
	(in millions)
Net unrealized (losses) gains	$	(149.1)	$	17.1	$	136.2

In 2020, we sold the common stock of publicly traded companies, which were primarily sales of our investment in CRISPR, resulting in the following:


	2020
	(in millions)
Proceeds received	$	437.6
Weighted-average cost basis	$	103.3

In 2022 and 2021, we did not sell any common stock of publicly traded companies.

As of December 31, 2022, the carrying value of our equity investments without readily determinable fair values, which are recorded in “Other assets” on our consolidated balance sheets, was $98.6 million.

Consolidated Statements of Operations - USD ($) shares in Millions, $ in Millions	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Revenues:
Revenue	$ 8,930.7	$ 7,574.4	$ 6,205.7
Costs and expenses:
Cost of sales	1,080.3	904.2	736.3
Research and development expenses	2,540.3	1,937.8	1,644.9
Acquired in-process research and development expenses	115.5	1,113.3	184.6
Selling, general and administrative expenses	944.7	840.1	770.5
Change in fair value of contingent consideration	(57.5)	(3.1)	13.1
Total costs and expenses	4,623.3	4,792.3	3,349.4
Income from operations	4,307.4	2,782.1	2,856.3
Interest income	144.6	4.9	22.2
Interest expense	(54.8)	(61.5)	(58.2)
Other (expense) income, net	(164.8)	4.9	296.6
Income before provision for income taxes	4,232.4	2,730.4	3,116.9
Provision for income taxes	910.4	388.3	405.2
Net income	$ 3,322.0	$ 2,342.1	$ 2,711.7
Net income per common share:
Basic (in dollars per share)	$ 12.97	$ 9.09	$ 10.44
Diluted (in dollars per share)	$ 12.82	$ 9.01	$ 10.29
Shares used in per share calculations:
Basic (in shares)	256.1	257.7	259.8
Diluted (in shares)	259.1	259.9	263.4
Product revenues, net
Revenues:
Revenue	$ 8,930.7	$ 7,573.4	$ 6,202.8
Other revenues
Revenues:
Revenue	$ 0.0	$ 1.0	$ 2.9

Consolidated Statements of Cash Flows - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Cash flows from operating activities:
Net income	$ 3,322.0	$ 2,342.1	$ 2,711.7
Adjustments to reconcile net income to net cash provided by operating activities:
Stock-based compensation expense	491.3	441.4	429.5
Depreciation expense	148.3	125.6	109.5
Deferred income taxes	(275.9)	(154.6)	277.3
Losses (gains) on equity securities	149.1	(17.1)	(311.9)
(Decrease) increase in fair value of contingent consideration	(57.5)	(3.1)	13.1
Other non-cash items, net	11.8	14.4	78.7
Changes in operating assets and liabilities:
Accounts receivable, net	(358.6)	(274.7)	(223.4)
Inventories	(136.4)	(92.8)	(132.0)
Prepaid expenses and other assets	(326.4)	(91.8)	(297.6)
Accounts payable	120.8	31.9	51.3
Accrued expenses	542.5	305.4	122.2
Other liabilities	498.9	16.8	425.1
Net cash provided by operating activities	4,129.9	2,643.5	3,253.5
Cash flows from investing activities:
Payment to acquire ViaCyte, net of cash acquired	(295.9)	0.0	0.0
Purchases of available-for-sale debt securities	(692.7)	(528.2)	(431.4)
Sales and maturities of available-for-sale debt securities	920.0	499.3	372.3
Sale of equity securities	0.0	0.0	437.6
Purchases of property and equipment	(204.7)	(235.0)	(259.8)
Investment in equity securities and notes receivable	(47.8)	(77.0)	(19.3)
Net cash (used in) provided by investing activities	(321.1)	(340.9)	99.4
Cash flows from financing activities:
Issuances of common stock under benefit plans	186.3	102.0	264.9
Repurchases of common stock	0.0	(1,425.4)	(539.1)
Payments in connection with common stock withheld for employee tax obligations	(172.0)	(135.9)	(200.3)
Payments on finance leases	(85.5)	(47.0)	(42.3)
Proceeds from finance leases	0.0	22.6	13.3
Other financing activities	3.5	5.7	(1.8)
Net cash used in financing activities	(67.7)	(1,478.0)	(505.3)
Effect of changes in exchange rates on cash	(29.2)	(13.4)	20.6
Net increase in cash, cash equivalents and restricted cash	3,711.9	811.2	2,868.2
Cash, cash equivalents and restricted cash—beginning of period	6,800.1	5,988.9	3,120.7
Cash, cash equivalents and restricted cash—end of period	10,512.0	6,800.1	5,988.9
Supplemental disclosure of cash flow information:
Cash paid for interest	52.3	56.3	54.5
Cash paid for income taxes	$ 1,057.8	$ 476.3	$ 191.8

Intangible Assets and Goodwill	12 Months Ended
Intangible Assets and Goodwill	Dec. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
Intangible Assets and Goodwill	Intangible Assets and Goodwill Intangible Assets As of December 31, 2022 and 2021, we had $603.6 million and $400.0 million, respectively, of in-process research and development intangible assets classified as “Intangible assets” on our consolidated balance sheets. In 2022, we recorded a $216.6 million in-process research and development intangible asset resulting from our acquisition of ViaCyte, which is described in Note C, “Business Combination,” and recorded a $13.0 million impairment of an in-process research and development intangible asset to “Research and development expenses,” due to a decision to revise the scope of certain acquired gene-editing programs. Goodwill As of December 31, 2022 and 2021, we had goodwill of $1.1 billion and $1.0 billion, respectively, on our consolidated balance sheets. During 2022, we recorded goodwill of $85.8 million related to our acquisition of ViaCyte, which is described in Note C, “Business Combination.”

Property and Equipment - Additional Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Property, Plant and Equipment [Abstract]
Depreciation expense	$ 148.3	$ 125.6	$ 109.5

Common Stock, Preferred Stock and Equity Plans - Performance-based RSUs (PSUs) (Details) $ / shares in Units, shares in Thousands, $ in Millions	12 Months Ended
	Dec. 31, 2022 USD ($) installment $ / shares shares	Dec. 31, 2021 USD ($) $ / shares shares	Dec. 31, 2020 USD ($)
Performance-based RSUs
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Potential awards, percent of target shares, minimum	0.00%
Potential awards, percent of target shares, maximum	200.00%
Number of installments \| installment	3
Number of Units
Beginning of the period (in shares) \| shares	1,078
Granted (in shares) \| shares	608
Vested (in shares) \| shares	(426)
Cancelled (in shares) \| shares	(33)
End of the period (in shares) \| shares	1,227	1,078
Weighted-average  Grant-date Fair Value
Beginning of the period (in dollars per share) \| $ / shares	$ 215.85
Granted (in dollars per share) \| $ / shares	247.26
Vested (in dollars per share) \| $ / shares	203.75
Cancelled (in dollars per share) \| $ / shares	222.16
End of the period (in dollars per share) \| $ / shares	$ 226.75	$ 215.85
Restricted stock vested in period, total fair value \| $	$ 98.7	$ 92.2	$ 138.5
Financial performance shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of installments \| installment	3
Vesting period	3 years
Tranche one \| Performance-based RSUs
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percent of awards in tranche	50.00%
Performance period	1 year
Vesting period	3 years
Tranche one \| Financial performance shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting percentage	33.30%
Tranche two \| Performance-based RSUs
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percent of awards in tranche	50.00%
Performance period	3 years
Vesting period	3 years
Tranche two \| Financial performance shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting percentage	33.30%
Tranche three \| Financial performance shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting percentage	33.30%

Nature of Business and Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2022

Accounting Policies [Abstract]

Schedule of Property and Equipment


Description						Estimated Useful Life
Buildings and improvements						15 to 40 years
Laboratory equipment, other equipment and furniture						7 to 10 years
Leasehold improvements; assets under finance leases						The shorter of the useful life of the assets or the estimated remaining term of the associated lease
Computers and software						3 to 5 years

“Property and equipment, net” consisted of the following:


	As of December 31,
	2022		2021
	(in millions)
Buildings and improvements	$	903.1	$	892.5
Laboratory equipment, other equipment and furniture	476.5		407.3
Leasehold improvements	410.9		363.5
Computers and software	312.1		293.7
Land	33.1		33.1
Total property and equipment, gross	2,135.7		1,990.1
Less: accumulated depreciation	(1,027.3)		(896.0)
Total property and equipment, net	$	1,108.4	$	1,094.1

Acquired In-Process Research and Development and Other Arrangements

12 Months Ended

Dec. 31, 2022

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Acquired In-Process Research and Development and Other Arrangements

We have entered into numerous agreements with third parties to collaborate on research, development and commercialization programs, license technologies, or acquire assets. Our “Acquired in-process research and development expenses” included $115.5 million, $1.1 billion and $184.6 million in 2022, 2021 and 2020, respectively, related to upfront, contingent milestone, or other payments pursuant to our business development transactions, including collaborations, licenses of third-party technologies, and asset acquisitions that qualify as in-process research and development.

In-license Agreements

We have entered into several in-license agreements to advance and obtain access to technologies and services related to our research and early-development activities. We are generally required to make an upfront payment upon execution of our license agreements; development, regulatory and commercialization milestones payments upon the achievement of certain product research, development and commercialization objectives; and royalty payments on future sales, if any, of commercial products resulting from our collaborations.

Pursuant to the terms of our in-license agreements, our collaborators typically lead the discovery efforts and we lead all preclinical, development and commercialization activities associated with the advancement of any product candidates and fund all expenses.

We typically can terminate our in-license agreements by providing advance notice to our collaborators. Our license agreements may be terminated by either party for a material breach by the other, subject to notice and cure provisions. Unless earlier terminated, these license agreements generally remain in effect until the date on which the royalty term and all payment obligations with respect to all products in all countries have expired.

CRISPR Therapeutics AG - CRISPR-Cas9 Gene-editing Therapies

In 2015, we entered into a strategic collaboration, option and license agreement (the “CRISPR Agreement”) with CRISPR Therapeutics AG and its affiliates (“CRISPR”) to collaborate on the discovery and development of potential new treatments aimed at the underlying genetic causes of human diseases using CRISPR-Cas9 gene-editing technology. We had the exclusive right to license certain targets. In 2019, we elected to exclusively license three targets, including CF, pursuant to the CRISPR Agreement. For each of the three targets that we elected to license, CRISPR has the potential to receive up to an additional $410.0 million in development, regulatory and commercial milestones as well as royalties on net product sales.

In 2017, we entered into a joint development and commercialization agreement with CRISPR pursuant to the terms of the CRISPR Agreement (the “Original CTX001 JDCA”), under which we and CRISPR were co-developing and preparing to co-commercialize exagamglogene autotemcel (“exa-cel”), formerly known as CTX001, for the treatment of hemoglobinopathies, including treatments for sickle cell disease and transfusion-dependent beta thalassemia.

In the second quarter of 2021, we and CRISPR amended and restated the Original CTX001 JDCA (the “A&R JDCA”), pursuant to which the parties agreed to, among other things, (a) adjust the governance structure for the collaboration and adjust the responsibilities of each party thereunder; (b) adjust the allocation of net profits and net losses between the parties; and (c) exclusively license (subject to CRISPR’s reserved rights to conduct certain activities) certain intellectual property rights to us relating to the products that may be researched, developed, manufactured and commercialized under such agreement.

Pursuant to the A&R JDCA, we lead global development, manufacturing and commercialization of exa-cel, with support from CRISPR. Subject to the terms and conditions of the A&R JDCA, we conduct all research, development, manufacturing and commercialization activities relating to the product candidates and products under the A&R JDCA (including exa-cel) throughout the world subject to CRISPR’s reserved right to conduct certain activities.

In connection with the A&R JDCA, we made a $900.0 million upfront payment to CRISPR in the second quarter of 2021. We concluded that we did not have any alternative future use for the acquired in-process research and development and recorded this upfront payment to “Acquired in-process research and development expenses.” CRISPR has the potential to receive an additional one-time $200.0 million milestone payment upon receipt of the first marketing approval of exa-cel from the U.S. Food and Drug Administration or the European Commission.

We and CRISPR shared equally all expenses incurred under the Original CTX001 JDCA. On July 1, 2021, the net profits and net losses incurred with respect to exa-cel pursuant to the A&R JDCA began to be allocated 60% to us and 40% to CRISPR, subject to certain adjustments, while all other product candidates and products continue to have net profits and net losses shared equally between the parties. We concluded that the Original CTX001 JDCA and the A&R JDCA are cost-sharing arrangements, which result in the net impact of the arrangements being recorded in “Total costs and expenses” within our consolidated statements of operations. During the three years ended December 31, 2022, we recognized the following amounts in total, not including amounts recorded to “Acquired in-process research and development expenses,” related to these agreements:


	2022		2021		2020
	(in millions)
Total expenses incurred under the Original CTX001 JDCA and A&R JDCA	$	365.8	$	230.4	$	101.2
Vertex’s share recognized in “Total costs and expenses” in our consolidated statements of operations	251.1		129.0		50.6

Entrada Therapeutics, Inc.

In December 2022, we announced a strategic collaboration and license agreement (the “Entrada Agreement”) with Entrada Therapeutics, Inc. (“Entrada”) focused on discovering and developing intracellular Endosomal Escape Vehicle (EEV) therapeutics for myotonic dystrophy type 1 (“DM1”). In February 2023, the Entrada Agreement closed upon, among other things, the satisfaction of customary closing conditions and the expiration of the waiting period under the Hart-Scott-Rodino Antitrust Improvements Act, resulting in no financial statement impact during 2022. The collaboration includes Entrada’s program for DM1, ENTR-701, which is in late preclinical development. Upon closing, we made an upfront payment of approximately $224.0 million to Entrada, and purchased approximately $26.0 million of Entrada’s common stock in connection with the Entrada Agreements. Entrada is eligible to receive up to an additional $485.0 million in research, development, regulatory and commercial milestones for any products that may result from the Entrada Agreement, as well as royalties on net product sales. We will account for the Entrada Agreement in the first quarter of 2023.

Verve Therapeutics, Inc.

In 2022, we entered into a strategic collaboration and license agreement with Verve Therapeutics, Inc. (“Verve”) focused on discovering and developing an in vivo gene-editing program for a liver disease. Under the terms of the agreement, we made a $25.0 million upfront payment to Verve and also purchased $35.0 million of Verve’s common stock in connection with the agreement. Verve is also eligible to receive up to $66.0 million in success payments, up to an additional $340.0 million in development, regulatory and commercial milestones for any products that may result from the collaboration agreement, and royalties on net product sales. We determined that substantially all the fair value of the collaboration agreement was attributable to in-process research and development and no substantive processes were acquired that would constitute a business. We concluded that there is no alternative future use for the acquired in-process research and development and recorded the upfront payment to “Acquired in-process research and development expenses.” The investment in Verve’s common stock is recorded at fair value on our consolidated balance sheet within “Marketable securities.”

ApoLo1 Bio, LLC

In 2016, we entered into a strategic collaboration and license agreement with ApoLo1 Bio, LLC (“ApoLo1”) related to our drug discovery efforts in APOL1-mediated kidney disease. In 2021, based on positive results from a Phase 2 proof-of-concept study of VX-147 in patients with APOL1-mediated focal segmental glomerulosclerosis, we paid ApoLo1 a $15.0 million milestone and exercised our $60.0 million option to buy-out all future development milestones, regulatory milestones, and future royalties on net product sales. We recorded these payments to “Acquired in-process research and development expenses” because we concluded that we did not have any alternative future use for the acquired in-process research and development.

Moderna, Inc.

In 2016, we entered into a strategic collaboration and licensing agreement with Moderna, Inc. (“Moderna”), pursuant to which the parties are seeking to identify and develop messenger ribonucleic acid (“mRNA”) therapeutics encoding cystic fibrosis transmembrane conductance regulator for the treatment of CF.

In 2020, we entered into a new strategic collaboration and licensing agreement with Moderna (the “2020 Moderna Agreement”) aimed at the discovery and development of lipid nanoparticles and mRNAs that can deliver gene-editing therapies to lung cells for the treatment of CF. Pursuant to the 2020 Moderna Agreement, we paid Moderna an upfront payment of $75.0 million and Moderna is eligible to receive up to $380.0 million in development, regulatory and commercial milestones as well as royalties on net product sales. We determined that substantially all the fair value of the 2020 Moderna Agreement was attributable to in-process research and development and no substantive processes were acquired that would constitute a business. We concluded that we did not have any alternative future use for the acquired in-process research and development and recorded the upfront payment to “Acquired in-process research and development expenses.”

Asset Acquisition

Catalyst Biosciences, Inc.

In 2022, pursuant to an asset purchase agreement, we acquired from Catalyst Biosciences, Inc.’s a portfolio of protease medicines that target the complement system and related intellectual property, including CB 2782-PEG, which is a pre-clinical complement component 3 degrader program for geographic atrophy in dry age-related macular degeneration. We determined that substantially all the fair value acquired is concentrated in the CB-2782 PEG in-process research and development assets, which did not constitute a business, and for which we determined there was no alternative future use. As a result, we recorded our $60.0 million upfront payment to “Acquired in-process research and development expenses.”

Additional In-License Agreements and Other Arrangements

In addition to the agreements described above, we recorded upfront, option and milestone payments totaling $30.5 million in 2022, $138.3 million in 2021 and $109.6 million in 2020 to “Acquired in-process research and development expenses” related to additional in-license agreements and other business development transactions that we do not consider to be individually significant to our consolidated financial statements. These payments included upfront payments of $31.0 million to Mammoth Biosciences, Inc. (“Mammoth”) and $25.0 million to Arbor Biotechnologies, Inc. (“Arbor”) in 2021, and $40.0 million to Skyhawk Therapeutics, Inc. (“Skyhawk”) in 2020.

For Mammoth, Arbor, Skyhawk, and several other in-license agreements that we entered into prior to 2022 that are not individually significant to our consolidated financial statements, we determined that substantially all the fair value of each individual agreement was attributable to in-process research and development and no substantive processes were acquired that would constitute a business. We concluded that we did not have any alternative future use for the acquired in-process research and development associated with the agreements and recorded the upfront payments for these agreements to “Acquired in-process research and development expenses.” Please refer to Note E, “Fair Value Measurements,” and Note F, “Marketable Securities and Equity Investments,” for further information regarding our investments in our collaborators.

Out-license Agreements

We have entered into licensing agreements pursuant to which we have out-licensed rights to certain product candidates to

third-party collaborators. Pursuant to these out-license agreements, our collaborators become responsible for all costs related to the continued development of such product candidates and obtain development and commercialization rights to these product candidates. Depending on the terms of the agreements, our collaborators may be required to make upfront payments, milestone payments upon the achievement of certain product research and development objectives and may also be required to pay royalties on future sales, if any, of commercial products resulting from the collaboration. The termination provisions associated with these collaborations are generally the same as those described above related to our in-license agreements.

Cystic Fibrosis Foundation

In 2004, we entered into a collaboration agreement with the Cystic Fibrosis Foundation, as successor in interest to the Cystic Fibrosis Foundation Therapeutics, Inc., to support research and development activities. Pursuant to the collaboration agreement, as amended, we have agreed to pay tiered royalties ranging from single digits to sub-teens on covered compounds first synthesized and/or tested during a research term on or before February 28, 2014, including ivacaftor, lumacaftor and tezacaftor and royalties ranging from low-single digits to mid-single digits on potential net sales of certain compounds first synthesized and/or tested between March 1, 2014 and August 31, 2016, including elexacaftor. We do not have any royalty obligations on compounds first synthesized and tested on or after September 1, 2016. For combination products, such as ORKAMBI, SYMDEKO/SYMKEVI and TRIKAFTA/KAFTRIO, sales are allocated equally to each of the active pharmaceutical ingredients in the combination product. We record our royalties payable to the Cystic Fibrosis Foundation to “Cost of sales.”

Commitments and Contingencies (Details) - USD ($)	1 Months Ended
Commitments and Contingencies (Details) - USD ($)	Jul. 31, 2022	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Line of Credit Facility [Line Items]
Indemnification claims		$ 0
Contingent liabilities		$ 0	$ 0
Revolving Credit Facility
Line of Credit Facility [Line Items]
Line of credit facility, maximum borrowing capacity	$ 500,000,000			$ 2,000,000,000	$ 500,000,000
Line of credit facility, additional borrowing capacity	$ 500,000,000
Debt covenant, consolidated leverage ratio	3.50
Debt covenant, increase in consolidated leverage ratio	4.00
Revolving Credit Facility \| Base Rate \| Minimum
Line of Credit Facility [Line Items]
Basis spread on variable rate (as a percent)	0.00%
Revolving Credit Facility \| Base Rate \| Maximum
Line of Credit Facility [Line Items]
Basis spread on variable rate (as a percent)	0.50%
Revolving Credit Facility \| SOFR Loan \| Minimum
Line of Credit Facility [Line Items]
Basis spread on variable rate (as a percent)	1.00%
Revolving Credit Facility \| SOFR Loan \| Maximum
Line of Credit Facility [Line Items]
Basis spread on variable rate (as a percent)	1.50%
Letter of Credit
Line of Credit Facility [Line Items]
Line of credit facility, maximum borrowing capacity	$ 100,000,000

Business Combination - Schedule of Assets Acquired and Liabilities Assumed (Details) - USD ($) $ in Millions	Dec. 31, 2022	Sep. 27, 2022	Dec. 31, 2021
Business Acquisition [Line Items]
Goodwill	$ 1,088.0		$ 1,002.2
ViaCyte
Business Acquisition [Line Items]
Cash and cash equivalents		$ 19.1
Goodwill	$ 85.8	85.8
Intangible asset		216.6
Net other liabilities		(6.5)
Total purchase price		$ 315.0

- Definition

+ References + Details

Stock-based Compensation Expense

12 Months Ended

Dec. 31, 2022

Share-Based Payment Arrangement [Abstract]

Stock-based Compensation Expense

Stock-based Compensation ExpenseWe recognize share-based payments to employees as compensation expense using the fair value method. The fair value of stock options and shares purchased pursuant to the ESPP is calculated using the Black-Scholes option pricing model. The fair value of restricted stock units, including PSUs, is based on the intrinsic value on the date of grant. Stock-based compensation, measured at the grant date based on the fair value of the award, is typically recognized as expense ratably over the requisite service period.

The effect of stock-based compensation expense during the three years ended December 31, 2022 was as follows:


	2022		2021		2020
	(in millions)
Stock-based compensation expense by line item:
Cost of sales	$	9.4	$	6.3	$	5.6
Research and development expenses	297.9		268.3		262.7
Selling, general and administrative expenses	184.0		166.8		161.2
Total stock-based compensation expense included in costs and expenses	491.3		441.4		429.5
Income tax effect	(144.1)		(82.9)		(147.0)
Total stock-based compensation included in costs and expenses, net of tax	$	347.2	$	358.5	$	282.5

The stock-based compensation expense by type of award during the three years ended December 31, 2022 was as follows:


	2022		2021		2020
	(in millions)
Stock-based compensation expense by type of award:
Restricted stock units (including PSUs)	$	456.1	$	384.3	$	360.4
Stock options	17.6		36.8		59.7
ESPP share issuances	16.7		24.4		13.0
Stock-based compensation expense related to inventories	0.9		(4.1)		(3.6)
Total stock-based compensation expense included in costs and expenses	$	491.3	$	441.4	$	429.5

We capitalize a portion of our stock-based compensation expense to inventories, all of which is attributable to employees who support the manufacturing of our products.

The following table sets forth our unrecognized stock-based compensation expense as of December 31, 2022, by type of award and the weighted-average period over which that expense is expected to be recognized:


	As of December 31, 2022
	Unrecognized Expense		Weighted-average Recognition Period
	(in millions)		(in years)
Type of award:
Restricted stock units (including PSUs)	$	477.9	1.93
Stock options	2.2		0.42
ESPP share issuances	11.3		0.61
Total unrecognized stock-based compensation expense	$	491.4

Stock Options

In each of the three years ended December 31, 2022, we issued stock options to our non-employee directors. We use the Black-Scholes option pricing model to estimate the fair value of stock options at the grant date. The Black-Scholes option pricing model uses the option exercise price as well as estimates and assumptions related to the expected price volatility of our stock, the rate of return on risk-free investments, the expected period during which the options will be outstanding, and the expected dividend yield for our stock to estimate the fair value of a stock option on the grant date. The options granted during 2022, 2021 and 2020 had a weighted-average grant-date fair value per share of $89.65, $65.94 and $88.37,

respectively.

The fair value of each option granted during 2022, 2021 and 2020 was estimated on the date of grant using the Black-Scholes option pricing model with the following weighted-average assumptions:


	2022	2021	2020
Stock options granted	20,079	27,302	22,636

Expected stock price volatility	34.03%	35.03%	35.87%
Risk-free interest rate	2.93%	0.86%	0.43%
Expected term of options (in years)	4.36	4.50	4.67
Expected annual dividends	—	—	—

The weighted-average valuation assumptions were determined as follows:

•Expected stock price volatility: Expected stock price volatility is calculated using the trailing one-month average of daily implied volatilities prior to the grant date. Implied volatility is based on options to purchase our stock with remaining terms of greater than one year that are regularly traded in the market.

•Risk-free interest rate: We base the risk-free interest rate on the interest rate payable on U.S. Treasury securities in effect at the time of grant for a period that is commensurate with the assumed expected option term.

•Expected term of options: The expected term of options represents the period of time options are expected to be outstanding. We use historical data to estimate employee exercise and post-vest termination behavior. We believe that all groups of employees exhibit similar exercise and post-vest termination behavior and therefore do not stratify employees into multiple groups in determining the expected term of options.

•Expected annual dividends: The estimate for annual dividends is $0.00 because we have not historically paid, and do not intend for the foreseeable future to pay, a dividend.

Restricted Stock Units and Performance-based Restricted Stock Units

We award restricted stock units with service conditions, which are generally the vesting periods of the awards.

As described in Note N, “Common Stock, Preferred Stock and Equity Plans,” we grant PSUs to certain members of senior management. Our financial-based PSUs vest in three equal installments over a three-year period and are expensed ratably over that same period based upon an assessment of the likely level of achievement. Our non-financial based PSUs cliff vest at the end of the three-year performance period and are expensed on a straight-line basis over that same period based upon an assessment of the likely level of achievement.

Employee Stock Purchase Plan

The weighted-average fair value of each purchase right granted during 2022, 2021 and 2020 was $79.36, $51.71 and $65.88, respectively. The following table reflects the weighted-average assumptions used in the Black-Scholes option pricing model for 2022, 2021 and 2020:


	2022	2021	2020
Expected stock price volatility	33.55%	34.06%	37.70%
Risk-free interest rate	4.05%	0.05%	0.11%
Expected term (in years)	0.71	0.69	0.71
Expected annual dividends	—	—	—

The weighted-average assumptions used in our Black-Scholes option pricing model were determined utilizing calculations similar to those described under Stock Options above.

Additional Balance Sheet Detail

12 Months Ended

Dec. 31, 2022

Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]

Additional Balance Sheet Detail

“Prepaid expenses and other current assets” consisted of the following:


	As of December 31,
	2022		2021
	(in millions)
Tax related prepaid and receivables	$	319.8	$	358.6
Prepaid expenses	111.8		83.5
Fair value of cash flow hedges	47.5		44.5
Other	74.4		59.2
Total	$	553.5	$	545.8

“Accrued expenses” consisted of the following:


	As of December 31,
	2022		2021
	(in millions)
Product revenue accruals	$	1,300.8	$	847.4
Payroll and benefits	246.5		191.3
Research, development and commercial contract costs	198.7		171.6
Royalty payable	215.0		200.4
Tax related accruals	123.3		211.3
Other	42.4		56.6
Total	$	2,126.7	$	1,678.6

“Other current liabilities” consisted of the following:


	As of December 31,
	2022		2021
	(in millions)
Contract liabilities	$	159.6	$	171.7
Finance lease liabilities	40.8		46.9
Operating lease liabilities	48.6		33.3
Other	62.5		16.5
Total	$	311.5	$	268.4

“Other long-term liabilities” consisted of the following:


	As of December 31,
	2022		2021
	(in millions)
Tax related liabilities	$	452.8	$	—
Contingent consideration	114.4		186.5
Other	118.6		116.8
Total	$	685.8	$	303.3

Cash, Cash Equivalents and Restricted Cash Presented in Consolidated Statements of Cash Flows

The cash, cash equivalents and restricted cash balances at the beginning and ending of each period presented in our consolidated statements of cash flows consisted of the following:


	As of December 31,
	2022		2021		2020		2019
	(in millions)
Cash and cash equivalents	$	10,504.0	$	6,795.0	$	5,988.2	$	3,109.3
Prepaid expenses and other current assets	8.0		5.1		0.7		8.0
Other assets	—		—		—		3.4
Cash, cash equivalents and restricted cash per consolidated statements of cash flows	$	10,512.0	$	6,800.1	$	5,988.9	$	3,120.7

Our restricted cash, if any, is included in “Prepaid expenses and other current assets” and “Other assets” on our consolidated balance sheets.

Cloud Computing Service Contracts

As of December 31, 2022, “Other assets” included $40.2 million related to costs incurred to implement cloud computing service contracts. The amounts associated with cloud computing service contracts were not material to either our consolidated balance sheet as of December 31, 2021 or our consolidated statements of operations for 2022, 2021 and 2020.

Earnings Per Share - Schedule of Computation (Details) - USD ($) $ / shares in Units, shares in Millions, $ in Millions	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Antidilutive Securities Excluded from Computation of Earnings Per Share
Net income	$ 3,322.0	$ 2,342.1	$ 2,711.7
Basic weighted-average common shares outstanding (in shares)	256.1	257.7	259.8
Effect of potentially dilutive securities:
Employee stock purchase program (in shares)	0.0	0.0	0.1
Diluted weighted-average common shares outstanding (in shares)	259.1	259.9	263.4
Basic net income per common share (in dollars per share)	$ 12.97	$ 9.09	$ 10.44
Diluted net income per common share (in dollars per share)	$ 12.82	$ 9.01	$ 10.29
Stock options
Effect of potentially dilutive securities:
Share-based payment arrangements (in shares)	1.4	1.1	1.8
Restricted stock units (including PSUs)
Effect of potentially dilutive securities:
Share-based payment arrangements (in shares)	1.6	1.1	1.7

Marketable Securities and Equity Investments (Tables)

12 Months Ended

Dec. 31, 2022

Investments, Debt and Equity Securities [Abstract]

Summary of Cash, Cash Equivalents and Marketable Securities


	As of December 31, 2022								As of December 31, 2021
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Fair Value		Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Fair Value
	(in millions)
Cash equivalents:
Money market funds	$	5,162.6	$	—	$	—	$	5,162.6	$	3,478.1	$	—	$	—	$	3,478.1
Time deposits	2,000.0		—		—		2,000.0		—		—		—		—
Corporate debt securities	5.8		—		—		5.8		—		—		—		—
Commercial paper	204.5		—		—		204.5		—		—		—		—
Total cash equivalents	$	7,372.9	$	—	$	—	$	7,372.9	$	3,478.1	$	—	$	—	$	3,478.1
Marketable securities:
U.S. Treasury securities	$	—	$	—	$	—	$	—	$	86.6	$	—	$	(0.2)	$	86.4
Government-sponsored enterprise securities	127.0		0.2		(0.1)		127.1		69.0		—		—		69.0
Corporate debt securities	87.2		—		(0.2)		87.0		91.1		—		(0.2)		90.9
Commercial paper	55.8		—		—		55.8		252.8		—		(0.1)		252.7
Total marketable debt securities	270.0		0.2		(0.3)		269.9		499.5		—		(0.5)		499.0
Corporate equity securities	104.4		30.9		(18.5)		116.8		69.4		167.1		(5.6)		230.9
Total marketable securities	$	374.4	$	31.1	$	(18.8)	$	386.7	$	568.9	$	167.1	$	(6.1)	$	729.9

Available-for-sale debt securities were classified on our consolidated balance sheets at fair value as follows:


	December 31,
	2022		2021
	(in millions)
Cash and cash equivalents	$	5,372.9	$	3,478.1
Marketable securities	157.7		499.0
Other assets	112.2		—
Total	$	5,642.8	$	3,977.1

Available-for-sale debt securities by contractual maturity were as follows:


	December 31,
	2022		2021
	(in millions)
Matures within one year	$	5,530.6	$	3,912.3
Matures after one year through five years	112.2		64.8
Total	$	5,642.8	$	3,977.1

Schedule of Company's Net Unrealized (Losses) Gains on Corporate Equity Securities

During the three years ended December 31, 2022, our net unrealized (losses) gains on corporate equity securities held at the conclusion of each period were as follows:


	2022		2021		2020
	(in millions)
Net unrealized (losses) gains	$	(149.1)	$	17.1	$	136.2

Schedule of Sale of Equity Investments

In 2020, we sold the common stock of publicly traded companies, which were primarily sales of our investment in CRISPR, resulting in the following:


	2020
	(in millions)
Proceeds received	$	437.6
Weighted-average cost basis	$	103.3

Earnings Per Share

12 Months Ended

Dec. 31, 2022

Earnings Per Share [Abstract]

Earnings Per Share

The following table sets forth the computation of basic and diluted net income per common share for the periods ended:


	2022		2021		2020
	(in millions, except per share amounts)
Net income	$	3,322.0	$	2,342.1	$	2,711.7

Basic weighted-average common shares outstanding	256.1		257.7		259.8
Effect of potentially dilutive securities:
Stock options	1.4		1.1		1.8
Restricted stock units (including PSUs)	1.6		1.1		1.7
Employee stock purchase program	0.0		0.0		0.1
Diluted weighted-average common shares outstanding	259.1		259.9		263.4

Basic net income per common share	$	12.97	$	9.09	$	10.44
Diluted net income per common share	$	12.82	$	9.01	$	10.29

We did not include the securities in the following table in the computation of the diluted net income per common share because the effect would have been anti-dilutive during each period:


	2022	2021	2020
	(in millions)
Stock options	0.0	0.7	0.3
Unvested restricted stock units (including PSUs)	0.2	0.4	0.3

Commitments and Contingencies	12 Months Ended
Commitments and Contingencies	Dec. 31, 2022
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies 2022 Revolving Credit Facility In July 2022, Vertex and certain of its subsidiaries entered into a $500.0 million unsecured revolving facility (the “Credit Agreement”) with Bank of America, N.A., as administrative agent and the lenders referred to therein (the “Lenders”), which matures on July 1, 2027. The Credit Agreement was not drawn upon at closing and we have not drawn upon it to date. Amounts drawn pursuant to the Credit Agreement, if any, will be used for general corporate purposes. Subject to satisfaction of certain conditions, we may request that the borrowing capacity for the Credit Agreement be increased by an additional $500.0 million. Additionally, the Credit Agreement provides a sublimit of $100.0 million for letters of credit. Any amounts borrowed under the Credit Agreement will bear interest, at our option, at either a base rate or a Secured Overnight Financing Rate (“SOFR”), in each case plus an applicable margin. Under the Credit Agreement, the applicable margins on base rate loans range from 0.000% to 0.500% and the applicable margins on SOFR loans range from 1.000% to 1.500%, in each case based on our consolidated leverage ratio (the ratio of our total consolidated funded indebtedness to our consolidated EBITDA for the most recently completed four fiscal quarter period). Any amounts borrowed pursuant to the Credit Agreement are guaranteed by certain of our existing and future domestic subsidiaries, subject to certain exceptions. The Credit Agreement contains customary representations and warranties and affirmative and negative covenants, including a financial covenant to maintain subject to certain limited exceptions, a consolidated leverage ratio of 3.50 to 1.00, subject to an increase to 4.00 to 1.00 following a material acquisition. As of December 31, 2022, we were in compliance with the covenants described above. The Credit Agreement also contains customary events of default. In the case of a continuing event of default, the administrative agent would be entitled to exercise various remedies, including the acceleration of amounts due under outstanding loans. Direct costs related to the Credit Agreement are recorded over its term and were not material to our financial statements. Prior Credit Facilities In July 2022, in conjunction with entering our new credit agreement, we terminated the $500.0 million credit agreement we entered into in 2019. In September 2022, a $2.0 billion credit agreement we entered into in 2020 expired in accordance with its terms. Guaranties and Indemnifications As permitted under Massachusetts law, our Articles of Organization and By-laws provide that we will indemnify certain of our officers and directors for certain claims asserted against them in connection with their service as an officer or director. The maximum potential amount of future payments that we could be required to make under these indemnification provisions is unlimited. However, we have purchased directors’ and officers’ liability insurance policies that could reduce our monetary exposure and enable us to recover a portion of any future amounts paid. No indemnification claims currently are outstanding, and we believe the estimated fair value of these indemnification arrangements is minimal. We customarily agree in the ordinary course of our business to indemnification provisions in agreements with clinical trial investigators and sites in our product development programs, sponsored research agreements with academic and not-for-profit institutions, various comparable agreements involving parties performing services for us, and our real estate leases. We also customarily agree to certain indemnification provisions in our drug discovery, development and commercialization collaboration agreements. With respect to our clinical trials and sponsored research agreements, these indemnification provisions typically apply to any claim asserted against the investigator or the investigator’s institution relating to personal injury or property damage, violations of law or certain breaches of our contractual obligations arising out of the research or clinical testing of our compounds or product candidates. With respect to lease agreements, the indemnification provisions typically apply to claims asserted against the landlord relating to personal injury or property damage caused by us, to violations of law by us or to certain breaches of our contractual obligations. The indemnification provisions appearing in our collaboration agreements are similar to those for the other agreements discussed above, but in addition provide some limited indemnification for our collaborator in the event of third-party claims alleging infringement of intellectual property rights. In each of the cases above, the indemnification obligation generally survives the termination of the agreement for some extended period, although we believe the obligation typically has the most relevance during the contract term and for a short period of time thereafter. The maximum potential amount of future payments that we could be required to make under these provisions is generally unlimited. We have purchased insurance policies covering personal injury, property damage and general liability that reduce our exposure for indemnification and would enable us in many cases to recover all or a portion of any future amounts paid. We have never paid any material amounts to defend lawsuits or settle claims related to these indemnification provisions. Accordingly, we believe the estimated fair value of these indemnification arrangements is minimal. Other Contingencies We have certain contingent liabilities that arise in the ordinary course of our business activities. We accrue such contingent liabilities when it is probable that future expenditures will be made and such expenditures can be reasonably estimated. Other than our contingent consideration liabilities discussed in Note E, “Fair Value Measurements,” there were no material contingent liabilities accrued as of December 31, 2022 or 2021.

Nature of Business and Accounting Policies - Basis of Presentation (Details) $ in Millions	12 Months Ended
	Dec. 31, 2022 USD ($) segment	Dec. 31, 2021 USD ($)	Dec. 31, 2020 USD ($)
Accounting Policies [Abstract]
Number of operating segments \| segment	1
Acquired in-process research and development expenses \| $	$ 115.5	$ 1,113.3	$ 184.6

Nature of Business and Accounting Policies - Revenue Recognition (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Accounting Policies [Abstract]
Contract liabilities	$ 159.6	$ 171.7
Revenues related to performance obligations	$ 171.7	$ 191.5	$ 62.3

Business Combination (Tables)

12 Months Ended

Dec. 31, 2022

Business Combination and Asset Acquisition [Abstract]

Schedule of Assets Acquired and Liabilities Assumed

We accounted for the transaction as a business combination, and allocated the purchase price to the following assets acquired and liabilities assumed:


	As of September 27, 2022
	(in millions)
Cash and cash equivalents	$	19.1
Goodwill	85.8
Intangible asset	216.6
Net other liabilities	(6.5)
Total purchase price	$	315.0

Earnings Per Share - Anti-dilutive Securities (Details) - shares shares in Millions	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Stock options
Antidilutive Securities Excluded from Computation of Earnings Per Share
Antidilutive securities excluded from computation of earnings per share (in shares)	0.0	0.7	0.3
Unvested restricted stock units (including PSUs)
Antidilutive Securities Excluded from Computation of Earnings Per Share
Antidilutive securities excluded from computation of earnings per share (in shares)	0.2	0.4	0.3

Additional Balance Sheet Detail - Additional Cash Flow (Details) - USD ($) $ in Millions	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Restricted Cash and Cash Equivalents Items [Line Items]
Cash and cash equivalents	$ 10,504.0	$ 6,795.0	$ 5,988.2	$ 3,109.3
Cash, cash equivalents and restricted cash per consolidated statements of cash flows	10,512.0	6,800.1	5,988.9	3,120.7
Prepaid expenses and other current assets
Restricted Cash and Cash Equivalents Items [Line Items]
Restricted cash and cash equivalents	8.0	5.1	0.7	8.0
Other assets
Restricted Cash and Cash Equivalents Items [Line Items]
Restricted cash and cash equivalents	$ 0.0	$ 0.0	$ 0.0	$ 3.4

Leases (Tables)

12 Months Ended

Dec. 31, 2022

Leases [Abstract]

Schedule of Lease Cost

The components of lease cost recorded in our consolidated statements of operations were as follows:


	2022		2021		2020
	(in millions)
Operating lease cost	$	35.3	$	33.9	$	23.1
Finance lease cost
Amortization of leased assets	51.0		51.9		51.2
Interest on lease liabilities	43.5		47.4		50.2
Variable lease cost	39.8		33.6		30.8
Sublease income	(2.7)		(0.4)		(4.0)
Net lease cost	$	166.9	$	166.4	$	151.3

Schedule of Components of Lease in Balance Sheets

Our leases are included on our consolidated balance sheets as follows:


	As of December 31,
	2022		2021
	(in millions)
Finance leases
Property and equipment, net	$	315.5	$	400.1
Total finance lease assets	$	315.5	$	400.1

Other current liabilities	$	40.8	$	46.9
Long-term finance lease liabilities	430.8		509.8
Total finance lease liabilities	$	471.6	$	556.7

Operating leases
Operating lease assets	$	347.4	$	330.3
Total operating lease assets	$	347.4	$	330.3

Other current liabilities	$	48.6	$	33.3
Long-term operating lease liabilities	379.5		377.4
Total operating lease liabilities	$	428.1	$	410.7

Schedule of Finance Lease, Liability, Maturity

Maturities of our finance and operating lease liabilities as of December 31, 2022 were as follows:


Year	Finance Leases		Operating Leases		Total
	(in millions)
2023	$	76.0	$	58.4	$	134.4
2024	88.7		44.3		133.0
2025	89.0		40.2		129.2
2026	89.3		39.4		128.7
2027	89.7		35.3		125.0
Thereafter	233.6		273.7		507.3
Total lease payments	666.3		491.3		1,157.6
Less: amount representing interest	(194.7)		(63.2)		(257.9)
Present value of lease liabilities	$	471.6	$	428.1	$	899.7

Schedule of Operating Lease, Liability, Maturity

Maturities of our finance and operating lease liabilities as of December 31, 2022 were as follows:


Year	Finance Leases		Operating Leases		Total
	(in millions)
2023	$	76.0	$	58.4	$	134.4
2024	88.7		44.3		133.0
2025	89.0		40.2		129.2
2026	89.3		39.4		128.7
2027	89.7		35.3		125.0
Thereafter	233.6		273.7		507.3
Total lease payments	666.3		491.3		1,157.6
Less: amount representing interest	(194.7)		(63.2)		(257.9)
Present value of lease liabilities	$	471.6	$	428.1	$	899.7

Schedule of Weighted-Average Remaining Lease Terms and Discount Rates

The weighted-average remaining lease terms and discount rates related to our leases were as follows:


	As of December 31,
	2022		2021
Weighted-average remaining lease term (in years)
Finance leases	10.60		10.73
Operating leases	11.57		12.81

Weighted-average discount rate
Finance leases	8.36	%	8.11	%
Operating leases	2.46	%	2.19	%

Schedule of Supplemental Cash Flow Information

Supplemental cash flow information related to our leases was as follows:


	2022		2021		2020
	(in millions)
Cash paid for amounts included in the measurement of lease liabilities
Operating cash flows from operating leases	$	50.8	$	21.5	$	16.3
Operating cash flows from finance leases	$	42.5	$	46.2	$	48.9
Financing cash flows from finance leases	$	85.5	$	47.0	$	42.3

Right-of-use assets obtained in exchange for lease obligations
Operating leases	$	58.6	$	36.3	$	293.6
Finance leases	$	—	$	—	$	33.1

Common Stock, Preferred Stock and Equity Plans

12 Months Ended

Dec. 31, 2022

Equity [Abstract]

Common Stock, Preferred Stock and Equity Plans

Common Stock and Preferred Stock

We are authorized to issue 500.0 million shares of common stock. Holders of common stock are entitled to one vote per share. Holders of common stock are entitled to receive dividends, if and when declared by our Board of Directors, and to share ratably in our assets legally available for distribution to our shareholders in the event of liquidation. Holders of common stock have no preemptive, subscription, redemption or conversion rights. The holders of common stock do not have cumulative voting rights.

We are authorized to issue 1.0 million shares of preferred stock in one or more series and to fix the powers, designations, preferences and relative participating, option or other rights thereof, including dividend rights, conversion rights, voting rights, redemption terms, liquidation preferences and the number of shares constituting any series, without any further vote or action by our shareholders. As of December 31, 2022 and 2021, we had no shares of preferred stock issued or outstanding.

Share Repurchase Programs

In July 2019, our Board of Directors approved a share repurchase program (the “2019 Share Repurchase Program”), pursuant to which we repurchased $500.0 million of our common stock in 2019 and 2020. In 2020, we repurchased 2.1 million shares of our common stock under the 2019 Share Repurchase Program for an aggregate of $464.0 million.

In November 2020, our Board of Directors approved a share repurchase program (the “2020 Share Repurchase Program”), pursuant to which we repurchased $500.0 million of our common stock in 2020 and 2021. In 2021 and 2020, we repurchased 2.0 million and 0.3 million shares, respectively, of our common stock under the 2020 Share Repurchase Program for an aggregate of $424.9 million and $75.1 million, respectively.

In June 2021, our Board of Directors approved a share repurchase program (the “2021 Share Repurchase Program”), pursuant to which we were authorized to repurchase up to $1.5 billion of our common stock by December 31, 2022. In 2021, we repurchased 5.3 million shares of our common stock under the 2021 Share Repurchase Program for an aggregate of $1.0 billion. On December 31, 2022, the 2021 Share Repurchase Program expired with $499.7 million of the authorization remaining.

In February 2023, our Board of Directors approved a share repurchase program (the “2023 Share Repurchase Program”), pursuant to which we are authorized to repurchase up to $3.0 billion of our common stock. The 2023 Share Repurchase Program does not have an expiration date and can be discontinued at any time. We expect to fund repurchases of our common stock through a combination of cash on hand and cash generated by operations.

Stock and Option Plans

The purpose of each of our stock and option plans is to attract, retain and motivate our employees, consultants and directors. Awards granted under these plans can be nonstatutory stock options (“NSOs”), incentive stock options (“ISOs”), restricted stock units (“RSUs”) including performance-based RSUs (“PSUs”), restricted stock (“RSs”), or other equity-based awards, as specified in the individual plans.

Shares issued under all of our plans are funded through the issuance of new shares. The following table contains information about our equity plans:

As of December 31, 2022

Title of Plan

Group Eligible

Type of Award Granted

Awards Outstanding

Additional Awards Authorized for Grant

(in thousands)

2013 Stock and Option Plan

Employees, Non-employee Directors and Consultants

NSO, RS, RSU and PSU

6,553

19,695

2006 Stock and Option Plan

Employees, Non-employee Directors and Consultants

NSO, RS and RSU

114

—

Total

6,667

19,695

All options granted under our 2013 Stock and Option Plan (“2013 Plan”) and 2006 Stock and Option Plan (“2006 Plan”) were granted with an exercise price equal to the fair value of the underlying common stock on the date of grant. As of December 31, 2022, we are only authorized to make new equity awards under our 2013 Plan. Under the 2013 Plan, no stock options can be awarded with an exercise price less than the fair market value on the date of grant. In 2022, our shareholders approved an increase in the number of shares authorized for issuance pursuant to the 2013 Stock and Option Plan of 13.5 million shares.

In each of the three years ended December 31, 2022, we issued stock options to our non-employee directors. The grant date for our stock options was the date the award was approved by our Board of Directors or the date new directors were elected to our Board of Directors. All options awarded under our stock and option plans expire not more than 10 years from the grant date.

Stock Options

The following table summarizes information related to the outstanding and exercisable options during the year ended December 31, 2022:


	Stock Options	Weighted-average Exercise Price		Weighted-average Remaining Contractual Life	Aggregate Intrinsic Value
	(in thousands)	(per share)		(in years)	(in millions)
Outstanding at December 31, 2021	3,611	$	141.76
Granted	20	$	276.17
Exercised	(1,087)	$	133.50
Forfeited	(17)	$	181.49
Expired	—	$	—
Outstanding at December 31, 2022	2,527	$	146.11	4.67	$	355.6
Exercisable at December 31, 2022	2,446	$	144.94	4.61	$	347.1

The aggregate intrinsic value in the table above represents the total pre-tax amount, net of exercise price, that would have been received by option holders if all option holders had exercised all options with an exercise price lower than the market price on the last business day of 2022, which was $286.86 based on the average of the high and low price of our common stock on that date.

The total intrinsic value (the amount by which the fair market value exceeded the exercise price) of stock options exercised during 2022, 2021 and 2020 was $157.2 million, $43.0 million and $255.0 million, respectively. The total cash we received as a result of employee stock option exercises during 2022, 2021 and 2020 was $144.6 million, $64.2 million and $228.2 million, respectively.

The following table summarizes information about stock options outstanding and exercisable as of December 31, 2022:


	Options Outstanding				Options Exercisable
Range of Exercise Prices	Number Outstanding	Weighted-average Remaining Contractual Life	Weighted-average Exercise Price		Number Exercisable	Weighted-average Exercise Price
	(in thousands)	(in years)	(per share)		(in thousands)	(per share)
$45.11–$100.00	689	3.13	$	86.05	689	$	86.05
$100.01–$150.00	286	2.58	$	123.17	286	$	123.17
$150.01–$200.00	1,482	5.61	$	173.26	1,401	$	172.78
$200.01–$286.27	70	8.33	$	256.44	70	$	256.44
Total	2,527	4.67	$	146.11	2,446	$	144.94

Restricted Stock Units (excluding PSUs) and Restricted Stock

The following table summarizes our restricted stock unit activity during the year ended December 31, 2022:


	Restricted Stock Units (excluding PSUs)
	Number of Shares	Weighted-average Grant-date Fair Value
	(in thousands)	(per share)
Unvested at December 31, 2021	2,909	$	213.17
Granted	1,710	$	258.39
Vested	(1,445)	$	209.08
Cancelled	(261)	$	228.88
Unvested at December 31, 2022	2,913	$	240.54

The total fair value of restricted stock units and restricted stock that vested during 2022, 2021 and 2020 (measured based on the market price of our common stock on the date of vesting) was $372.5 million, $281.1 million and $391.7 million, respectively.

Performance-based RSUs (PSUs)

The potential range of shares issuable pursuant to our PSU awards range from 0% to 200% of the target shares based on financial and non-financial measures. Fifty percent of PSUs that could be earned have a one-year performance period with the amount actually earned dependent upon our financial performance and with vesting of the earned shares in three equal installments over a three-year period. The remaining 50% of PSUs that could be earned have a three-year performance period with the amount actually earned dependent upon the achievement of multiple clinical development milestones and with the earned shares cliff vesting at the end of the three-year performance period.

The following table summarizes our PSU activity during the year ended December 31, 2022:


	Performance-Based RSU
	Number of Units	Weighted-average Grant-date Fair Value
	(in thousands)	(per share)
Unvested at December 31, 2021 (1)	1,078	$	215.85
Granted (2)	608	$	247.26
Vested	(426)	$	203.75
Cancelled	(33)	$	222.16
Unvested at December 31, 2022	1,227	$	226.75

(1) “Unvested” represents our PSUs at target to the extent performance has not been certified plus the actual number of shares that continue to be subject to service conditions for which the performance has been achieved and certified.
(2) “Granted” represents (i) the target number of shares issuable for grants during 2022 and (ii) any change in the number of shares issuable pursuant to outstanding PSUs based on performance certification during 2022.

The total fair value of PSUs that vested during 2022, 2021 and 2020 (measured on the date of vesting) was $98.7 million, $92.2 million and $138.5 million, respectively.

Employee Stock Purchase Plan

We have an employee stock purchase plan (the “ESPP”). The ESPP permits eligible employees to enroll in a twelve-month offering period comprising two six-month purchase periods. Participants may purchase shares of our common stock, through payroll deductions, at a price equal to 85% of the fair market value of the common stock on the first day of the applicable twelve-month offering period, or the last day of the applicable six-month purchase period, whichever is lower. Purchase dates under the ESPP occur on or about May 14 and November 14 of each year. As of December 31, 2022, there were 1.5 million shares of common stock authorized for issuance pursuant to the ESPP.

In 2022, the following shares were issued to employees under the ESPP:


	Year Ended December 31, 2022
Number of shares (in thousands)	261
Average price paid per share	$	161.74

Employee Benefits

We have a 401(k) retirement plan (the “Vertex 401(k) Plan”) in which substantially all of our permanent U.S. employees are eligible to participate. Participants may contribute up to 60% of their annual compensation to the Vertex 401(k) Plan, subject to statutory limitations. We may declare discretionary matching contributions to the Vertex 401(k) Plan. We pay matching contributions in the form of cash. In 2022, 2021 and 2020, we contributed approximately $27.5 million, $21.8 million and $19.2 million to the plan, respectively.

Acquired In-Process Research and Development and Other Arrangements - Collaborative Arrangement Costs (Details) - Collaborative Arrangement, Transaction with Party to Collaborative Arrangement - CRISPR Therapeutics - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Collaborative arrangement costs	$ 365.8	$ 230.4	$ 101.2
Total collaborative arrangement costs included in costs and expenses
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Collaborative arrangement costs	$ 251.1	$ 129.0	$ 50.6

Common Stock, Preferred Stock and Equity Plans - Employee Benefits (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Equity [Abstract]
Maximum percentage of annual compensation contributed by the participant (percent)	60.00%
Defined contribution plan, cost	$ 27.5	$ 21.8	$ 19.2

Stock-based Compensation Expense (Details) - USD ($)	12 Months Ended
Stock-based Compensation Expense (Details) - USD ($)	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Stock-based compensation expense:
Stock-based compensation expense related to inventories	$ 491,300,000	$ 441,400,000	$ 429,500,000
Income tax effect	(144,100,000)	(82,900,000)	(147,000,000.0)
Total stock-based compensation included in costs and expenses, net of tax	347,200,000	358,500,000	282,500,000
Stock-based compensation expense related to inventories	900,000	(4,100,000)	(3,600,000)
Total stock-based compensation expense included in costs and expenses	491,300,000	$ 441,400,000	$ 429,500,000
Share-based Payment Arrangement, Additional Disclosure [Abstract]
Unrecognized Expense	$ 491,400,000
Weighted-average assumptions for options and ESPP subscriptions granted
Stock options granted (in shares)	20,079	27,302	22,636
Restricted stock units (including PSUs)
Stock-based compensation expense:
Stock-based compensation expense related to inventories	$ 456,100,000	$ 384,300,000	$ 360,400,000
Share-based Payment Arrangement, Additional Disclosure [Abstract]
Unrecognized Expense	$ 477,900,000
Weighted-average Recognition Period	1 year 11 months 4 days
Stock options
Stock-based compensation expense:
Stock-based compensation expense related to inventories	$ 17,600,000	$ 36,800,000	$ 59,700,000
Share-based Payment Arrangement, Additional Disclosure [Abstract]
Unrecognized Expense	$ 2,200,000
Weighted-average Recognition Period	5 months 1 day
Weighted-average assumptions for options and ESPP subscriptions granted
Expected stock price volatility (percent)	34.03%	35.03%	35.87%
Risk-free interest rate (percent)	2.93%	0.86%	0.43%
Expected term of options (in years)	4 years 4 months 9 days	4 years 6 months	4 years 8 months 1 day
Expected annual dividends	$ 0	$ 0	$ 0
ESPP share issuances
Stock-based compensation expense:
Stock-based compensation expense related to inventories	16,700,000	$ 24,400,000	$ 13,000,000.0
Share-based Payment Arrangement, Additional Disclosure [Abstract]
Unrecognized Expense	$ 11,300,000
Weighted-average Recognition Period	7 months 9 days
Weighted-average assumptions for options and ESPP subscriptions granted
Expected stock price volatility (percent)	33.55%	34.06%	37.70%
Risk-free interest rate (percent)	4.05%	0.05%	0.11%
Expected term of options (in years)	8 months 15 days	8 months 8 days	8 months 15 days
Expected annual dividends	$ 0	$ 0	$ 0
Cost of sales
Stock-based compensation expense:
Stock-based compensation expense related to inventories	9,400,000	6,300,000	5,600,000
Research and development expenses
Stock-based compensation expense:
Stock-based compensation expense related to inventories	297,900,000	268,300,000	262,700,000
Selling, general and administrative expenses
Stock-based compensation expense:
Stock-based compensation expense related to inventories	$ 184,000,000.0	$ 166,800,000	$ 161,200,000

Consolidated Statements of Comprehensive Income (Parenthetical) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Statement of Comprehensive Income [Abstract]
Unrealized (losses) gains on foreign currency forward contracts, net of tax	$ 1.0	$ (21.8)	$ 14.3

Leases - Components of Lease Expense (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Leases [Abstract]
Operating lease cost	$ 35.3	$ 33.9	$ 23.1
Finance lease cost
Amortization of leased assets	51.0	51.9	51.2
Interest on lease liabilities	43.5	47.4	50.2
Variable lease cost	39.8	33.6	30.8
Sublease income	(2.7)	(0.4)	(4.0)
Net lease cost	$ 166.9	$ 166.4	$ 151.3

Common Stock, Preferred Stock and Equity Plans - Outstanding and Vested Stock Options (Details) - USD ($) $ / shares in Units, $ in Millions	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Stock Options
Outstanding at beginning of period (in shares)	3,611,000
Granted (in shares)	20,079	27,302	22,636
Exercised (in shares)	(1,087,000)
Forfeited (in shares)	(17,000)
Expired (in shares)	0
Outstanding at end of period (in shares)	2,527,000	3,611,000
Exercisable (in shares)	2,446,000
Weighted-average Exercise Price
Outstanding at beginning of period (in dollars per share)	$ 141.76
Granted (in dollars per share)	276.17
Exercised (in dollars per share)	133.50
Forfeited (in dollars per share)	181.49
Expired (in dollars per share)	0
Outstanding at end of period (in dollars per share)	146.11	$ 141.76
Exercisable (in dollars per share)	$ 144.94
Weighted-average Remaining Contractual Life
Outstanding (in years)	4 years 8 months 1 day
Exercisable (in years)	4 years 7 months 9 days
Aggregate Intrinsic Value
Outstanding	$ 355.6
Exercisable	347.1
Total intrinsic value of stock options exercised	157.2	$ 43.0	$ 255.0
Total cash received from employees as a result of employee stock option exercises	$ 144.6	$ 64.2	$ 228.2
Weighted Average
Aggregate Intrinsic Value
Market share price (in dollars per share)	$ 286.86

Hedging - Notional Amount (Details) - Foreign currency forward contracts - Designated as hedging instruments - Cash Flow Hedging - USD ($) $ in Millions	Dec. 31, 2022	Dec. 31, 2021
Derivative [Line Items]
Notional amount of foreign currency forward contract	$ 2,201.5	$ 1,892.5
Euro
Derivative [Line Items]
Notional amount of foreign currency forward contract	1,497.7	1,364.5
British pound sterling
Derivative [Line Items]
Notional amount of foreign currency forward contract	247.4	287.7
Canadian dollar
Derivative [Line Items]
Notional amount of foreign currency forward contract	216.3	89.9
Australian dollar
Derivative [Line Items]
Notional amount of foreign currency forward contract	174.9	96.3
Swiss Franc
Derivative [Line Items]
Notional amount of foreign currency forward contract	$ 65.2	$ 54.1

Nature of Business and Accounting Policies - Business (Details)	12 Months Ended
	Dec. 31, 2022 medicine
Accounting Policies [Abstract]
Number of approved medicines	4

Leases - Balance Sheet Classification of Lease Assets and Liabilities (Details) - USD ($) $ in Millions	Dec. 31, 2022	Dec. 31, 2021
Finance leases
Property and equipment, net	$ 315.5	$ 400.1
Total finance lease assets	315.5	400.1
Finance lease liabilities	40.8	46.9
Long-term finance lease liabilities	430.8	509.8
Present value of lease liabilities	471.6	556.7
Operating leases
Total operating lease assets	347.4	330.3
Other current liabilities	48.6	33.3
Long-term operating lease liabilities	379.5	377.4
Present value of lease liabilities	$ 428.1	$ 410.7
Finance Lease, Right-of-Use Asset, Statement of Financial Position [Extensible List]	Property and equipment, net	Property and equipment, net
Finance Lease, Liability, Current, Statement of Financial Position [Extensible List]	Other current liabilities	Other current liabilities
Operating Lease, Liability, Current, Statement of Financial Position [Extensible List]	Other current liabilities	Other current liabilities

Inventories (Details) - USD ($) $ in Millions	Dec. 31, 2022	Dec. 31, 2021
Inventory Disclosure [Abstract]
Raw materials	$ 38.1	$ 42.4
Work-in-process	260.7	224.0
Finished goods	161.8	86.7
Total	$ 460.6	$ 353.1

Income Taxes - Components of Income and Provision for (Benefit from) Income Taxes (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Components of income (loss) before provision for (benefit from) income taxes
United States	$ 3,257.0	$ 2,030.7	$ 2,885.4
Foreign	975.4	699.7	231.5
Income before provision for income taxes	4,232.4	2,730.4	3,116.9
Current taxes:
Federal	779.0	374.9	71.4
State	34.9	26.5	18.9
Foreign	372.4	141.5	37.6
Total current taxes	1,186.3	542.9	127.9
Deferred taxes:
Federal	(404.0)	(36.9)	510.2
State	(11.0)	(19.3)	6.7
Foreign	139.1	(98.4)	(239.6)
Total deferred taxes	(275.9)	(154.6)	277.3
Provision for income taxes	$ 910.4	$ 388.3	$ 405.2

Marketable Securities and Equity Investments - Available-for-Sale Debt Securities by Contractual Maturity (Details) - USD ($) $ in Millions	Dec. 31, 2022	Dec. 31, 2021
Investments, Debt and Equity Securities [Abstract]
Matures within one year	$ 5,530.6	$ 3,912.3
Matures after one year through five years	112.2	64.8
Total	$ 5,642.8	$ 3,977.1

Property and Equipment (Tables)

12 Months Ended

Dec. 31, 2022

Property, Plant and Equipment [Abstract]

Schedule of Property and Equipment


Description						Estimated Useful Life
Buildings and improvements						15 to 40 years
Laboratory equipment, other equipment and furniture						7 to 10 years
Leasehold improvements; assets under finance leases						The shorter of the useful life of the assets or the estimated remaining term of the associated lease
Computers and software						3 to 5 years

“Property and equipment, net” consisted of the following:


	As of December 31,
	2022		2021
	(in millions)
Buildings and improvements	$	903.1	$	892.5
Laboratory equipment, other equipment and furniture	476.5		407.3
Leasehold improvements	410.9		363.5
Computers and software	312.1		293.7
Land	33.1		33.1
Total property and equipment, gross	2,135.7		1,990.1
Less: accumulated depreciation	(1,027.3)		(896.0)
Total property and equipment, net	$	1,108.4	$	1,094.1

Leases - Additional Information (Details) ft² in Thousands	12 Months Ended
Leases - Additional Information (Details) ft² in Thousands	Dec. 31, 2019 ft² renewal_option	Dec. 31, 2015 ft² term	Dec. 31, 2011 ft² lease building
Corporate Headquarters
Lessee, Lease, Description [Line Items]
Number of leases \| lease			2
Area of real estate property (in square feet)			1,100
Lease agreements number of buildings \| building			2
Option to extend lease term			15 years
Optional term of lease agreement (in years)			10 years
San Diego Lease
Lessee, Lease, Description [Line Items]
Area of real estate property (in square feet)		170
Length of lease		16 years
Amount of optional renewal terms \| term		2
Optional renewal term length		5 years
Jeffrey Leiden Center for Cell and Genetic Therapies
Lessee, Lease, Description [Line Items]
Area of real estate property (in square feet)	269
Optional term of lease agreement (in years)	10 years
Lease agreement initial term	16 years
Number of optional renewal terms \| renewal_option	2

Inventories (Tables)

12 Months Ended

Dec. 31, 2022

Inventory Disclosure [Abstract]

Schedule of Inventories by Type

“Inventories” consisted of the following:


	As of December 31,
	2022		2021
	(in millions)
Raw materials	$	38.1	$	42.4
Work-in-process	260.7		224.0
Finished goods	161.8		86.7
Total	$	460.6	$	353.1

Inventories

12 Months Ended

Dec. 31, 2022

Inventory Disclosure [Abstract]

Inventories

“Inventories” consisted of the following:


	As of December 31,
	2022		2021
	(in millions)
Raw materials	$	38.1	$	42.4
Work-in-process	260.7		224.0
Finished goods	161.8		86.7
Total	$	460.6	$	353.1

Nature of Business and Accounting Policies - Stock-Based Compensation Expense (Details)	12 Months Ended
	Dec. 31, 2022
Accounting Policies [Abstract]
Percentage of employees eligible for acceleration of equity awards (less than) (percent)	5.00%

Common Stock, Preferred Stock and Equity Plans - Restricted Stock and Restricted Stock Units (Details) - Restricted Stock Units (excluding PSUs) - USD ($) $ / shares in Units, shares in Thousands, $ in Millions	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Number of Shares
Beginning of the period (in shares)	2,909
Granted (in shares)	1,710
Vested (in shares)	(1,445)
Cancelled (in shares)	(261)
End of the period (in shares)	2,913	2,909
Weighted-average  Grant-date Fair Value
Beginning of the period (in dollars per share)	$ 213.17
Granted (in dollars per share)	258.39
Vested (in dollars per share)	209.08
Cancelled (in dollars per share)	228.88
End of the period (in dollars per share)	$ 240.54	$ 213.17
Restricted stock vested in period, total fair value	$ 372.5	$ 281.1	$ 391.7

Hedging - Cash Flow Hedging Instruments (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Derivative Instruments, Gain (Loss) [Line Items]
Product revenues, net	$ 8,930.7	$ 7,574.4	$ 6,205.7
Other (expense) income, net	(164.8)	4.9	296.6
Foreign Currency Forward Contract \| Reclassification out of Accumulated Other Comprehensive Income \| Foreign currency forward contracts \| Not designated as hedging instrument
Derivative Instruments, Gain (Loss) [Line Items]
Other (expense) income, net	(9.9)	(18.6)	22.1
Product revenues, net
Derivative Instruments, Gain (Loss) [Line Items]
Product revenues, net	8,930.7	7,573.4	6,202.8
Product revenues, net \| Foreign Currency Forward Contract \| Reclassification out of Accumulated Other Comprehensive Income \| Foreign currency forward contracts \| Designated as hedging instruments
Derivative Instruments, Gain (Loss) [Line Items]
Product revenues, net	$ 182.5	$ (30.0)	$ (3.7)

- Definition

+ References

+ Details

Nature of Business and Accounting Policies - Property and Equipment (Details)	12 Months Ended
	Dec. 31, 2022
Buildings and improvements \| Minimum
Property, Plant and Equipment [Line Items]
Property and equipment useful life	15 years
Buildings and improvements \| Maximum
Property, Plant and Equipment [Line Items]
Property and equipment useful life	40 years
Laboratory equipment, other equipment and furniture \| Minimum
Property, Plant and Equipment [Line Items]
Property and equipment useful life	7 years
Laboratory equipment, other equipment and furniture \| Maximum
Property, Plant and Equipment [Line Items]
Property and equipment useful life	10 years
Computers and software \| Minimum
Property, Plant and Equipment [Line Items]
Property and equipment useful life	3 years
Computers and software \| Maximum
Property, Plant and Equipment [Line Items]
Property and equipment useful life	5 years

Business Combination - Additional Information (Details) - ViaCyte	Sep. 27, 2022 USD ($)
Business Acquisition [Line Items]
Purchase price	$ 315,000,000
Goodwill expected to be tax deductible	0
Intangible asset	216,600,000
In Process Research and Development
Business Acquisition [Line Items]
Intangible asset	$ 216,600,000

Fair Value Measurements (Tables)

12 Months Ended

Dec. 31, 2022

Fair Value Disclosures [Abstract]

Schedule of Financial Assets Subject to Fair Value Measurements


	As of December 31, 2022								As of December 31, 2021
			Fair Value Hierarchy								Fair Value Hierarchy
	Total		Level 1		Level 2		Level 3		Total		Level 1		Level 2		Level 3
	(in millions)
Financial instruments carried at fair value (asset positions):
Cash equivalents:
Money market funds	$	5,162.6	$	5,162.6	$	—	$	—	$	3,478.1	$	3,478.1	$	—	$	—
Time deposits	2,000.0		—		2,000.0		—		—		—		—		—
Corporate debt securities	5.8		—		5.8		—		—		—		—		—
Commercial paper	204.5		—		204.5		—		—		—		—		—
Marketable securities:
Corporate equity securities	116.8		88.8		28.0		—		230.9		230.9		—		—
U.S. Treasury securities	—		—		—		—		86.4		86.4		—		—
Government-sponsored enterprise securities	127.1		127.1		—		—		69.0		69.0		—		—
Corporate debt securities	87.0		—		87.0		—		90.9		—		90.9		—
Commercial paper	55.8		—		55.8		—		252.7		—		252.7		—
Prepaid expenses and other current assets:
Foreign currency forward contracts	47.5		—		47.5		—		44.5		—		44.5		—
Other assets:
Foreign currency forward contracts	0.8		—		0.8		—		2.0		—		2.0		—
Total financial assets	$	7,807.9	$	5,378.5	$	2,429.4	$	—	$	4,254.5	$	3,864.4	$	390.1	$	—

Financial instruments carried at fair value (liability positions):
Other current liabilities:
Foreign currency forward contracts	$	(14.3)	$	—	$	(14.3)	$	—	$	(5.6)	$	—	$	(5.6)	$	—
Contingent consideration	(14.6)		—		—		(14.6)		—		—		—		—
Other long-term liabilities:
Foreign currency forward contracts	(0.9)		—		(0.9)		—		(2.7)		—		(2.7)		—
Contingent consideration	(114.4)		—		—		(114.4)		(186.5)		—		—		(186.5)
Total financial liabilities	$	(144.2)	$	—	$	(15.2)	$	(129.0)	$	(194.8)	$	—	$	(8.3)	$	(186.5)

Schedule of Fair Value of Our Contingent Consideration Liabilities

The following table represents a rollforward of the fair value of our contingent consideration liabilities:


	Year Ended December 31, 2022
	(in millions)
Balance at December 31, 2021	$	186.5
Decrease in fair value of contingent payments	(57.5)
Balance at December 31, 2022	$	129.0

Audit Information	12 Months Ended
Audit Information	Dec. 31, 2022
Audit Information [Abstract]
Auditor Firm ID	42
Auditor Name	Ernst & Young LLP
Auditor Location	Boston, Massachusetts

Common Stock, Preferred Stock and Equity Plans (Tables)

12 Months Ended

Dec. 31, 2022

Equity [Abstract]

Schedule of Stock and Stock Equity Plans

The following table contains information about our equity plans:

As of December 31, 2022

Title of Plan

Group Eligible

Type of Award Granted

Awards Outstanding

Additional Awards Authorized for Grant

(in thousands)

2013 Stock and Option Plan

Employees, Non-employee Directors and Consultants

NSO, RS, RSU and PSU

6,553

19,695

2006 Stock and Option Plan

Employees, Non-employee Directors and Consultants

NSO, RS and RSU

114

—

Total

6,667

19,695

Schedule of Outstanding and Vested Options

The following table summarizes information related to the outstanding and exercisable options during the year ended December 31, 2022:


	Stock Options	Weighted-average Exercise Price		Weighted-average Remaining Contractual Life	Aggregate Intrinsic Value
	(in thousands)	(per share)		(in years)	(in millions)
Outstanding at December 31, 2021	3,611	$	141.76
Granted	20	$	276.17
Exercised	(1,087)	$	133.50
Forfeited	(17)	$	181.49
Expired	—	$	—
Outstanding at December 31, 2022	2,527	$	146.11	4.67	$	355.6
Exercisable at December 31, 2022	2,446	$	144.94	4.61	$	347.1

Schedule of Stock Options Outstanding and Exercisable

The following table summarizes information about stock options outstanding and exercisable as of December 31, 2022:


	Options Outstanding				Options Exercisable
Range of Exercise Prices	Number Outstanding	Weighted-average Remaining Contractual Life	Weighted-average Exercise Price		Number Exercisable	Weighted-average Exercise Price
	(in thousands)	(in years)	(per share)		(in thousands)	(per share)
$45.11–$100.00	689	3.13	$	86.05	689	$	86.05
$100.01–$150.00	286	2.58	$	123.17	286	$	123.17
$150.01–$200.00	1,482	5.61	$	173.26	1,401	$	172.78
$200.01–$286.27	70	8.33	$	256.44	70	$	256.44
Total	2,527	4.67	$	146.11	2,446	$	144.94

Schedule of Restricted Stock and Restricted Stock Units Activity

The following table summarizes our restricted stock unit activity during the year ended December 31, 2022:


	Restricted Stock Units (excluding PSUs)
	Number of Shares	Weighted-average Grant-date Fair Value
	(in thousands)	(per share)
Unvested at December 31, 2021	2,909	$	213.17
Granted	1,710	$	258.39
Vested	(1,445)	$	209.08
Cancelled	(261)	$	228.88
Unvested at December 31, 2022	2,913	$	240.54

Schedule of PSU Activity

The following table summarizes our PSU activity during the year ended December 31, 2022:


	Performance-Based RSU
	Number of Units	Weighted-average Grant-date Fair Value
	(in thousands)	(per share)
Unvested at December 31, 2021 (1)	1,078	$	215.85
Granted (2)	608	$	247.26
Vested	(426)	$	203.75
Cancelled	(33)	$	222.16
Unvested at December 31, 2022	1,227	$	226.75

(1) “Unvested” represents our PSUs at target to the extent performance has not been certified plus the actual number of shares that continue to be subject to service conditions for which the performance has been achieved and certified.
(2) “Granted” represents (i) the target number of shares issuable for grants during 2022 and (ii) any change in the number of shares issuable pursuant to outstanding PSUs based on performance certification during 2022.

Schedule of Shares Issued Under Employee Stock Purchase Plan

In 2022, the following shares were issued to employees under the ESPP:


	Year Ended December 31, 2022
Number of shares (in thousands)	261
Average price paid per share	$	161.74

Additional Balance Sheet Detail (Tables)

12 Months Ended

Dec. 31, 2022

Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]

Schedule of Prepaid, and Other Assets

“Prepaid expenses and other current assets” consisted of the following:


	As of December 31,
	2022		2021
	(in millions)
Tax related prepaid and receivables	$	319.8	$	358.6
Prepaid expenses	111.8		83.5
Fair value of cash flow hedges	47.5		44.5
Other	74.4		59.2
Total	$	553.5	$	545.8

Summary of Accrued Expenses

“Accrued expenses” consisted of the following:


	As of December 31,
	2022		2021
	(in millions)
Product revenue accruals	$	1,300.8	$	847.4
Payroll and benefits	246.5		191.3
Research, development and commercial contract costs	198.7		171.6
Royalty payable	215.0		200.4
Tax related accruals	123.3		211.3
Other	42.4		56.6
Total	$	2,126.7	$	1,678.6

Summary of Other Current Liabilities

“Other current liabilities” consisted of the following:


	As of December 31,
	2022		2021
	(in millions)
Contract liabilities	$	159.6	$	171.7
Finance lease liabilities	40.8		46.9
Operating lease liabilities	48.6		33.3
Other	62.5		16.5
Total	$	311.5	$	268.4

Summary of Other Long Term Liabilities

“Other long-term liabilities” consisted of the following:


	As of December 31,
	2022		2021
	(in millions)
Tax related liabilities	$	452.8	$	—
Contingent consideration	114.4		186.5
Other	118.6		116.8
Total	$	685.8	$	303.3

Schedule of Additional Cash Flow Information

The cash, cash equivalents and restricted cash balances at the beginning and ending of each period presented in our consolidated statements of cash flows consisted of the following:


	As of December 31,
	2022		2021		2020		2019
	(in millions)
Cash and cash equivalents	$	10,504.0	$	6,795.0	$	5,988.2	$	3,109.3
Prepaid expenses and other current assets	8.0		5.1		0.7		8.0
Other assets	—		—		—		3.4
Cash, cash equivalents and restricted cash per consolidated statements of cash flows	$	10,512.0	$	6,800.1	$	5,988.9	$	3,120.7

Additional Balance Sheet Detail - Prepaid Expenses and Other Current Assets (Details) - USD ($) $ in Millions	Dec. 31, 2022	Dec. 31, 2021
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]
Tax related prepaid and receivables	$ 319.8	$ 358.6
Prepaid expenses	111.8	83.5
Fair value of cash flow hedges	47.5	44.5
Other	74.4	59.2
Prepaid expenses and other current assets	$ 553.5	$ 545.8

Hedging (Tables)

12 Months Ended

Dec. 31, 2022

Derivative Instruments and Hedging Activities Disclosure [Abstract]

Schedule of Cash Flow Hedging Instruments

The following table summarizes the notional amount in U.S. dollars of our outstanding foreign currency forward contracts designated as cash flow hedges under U.S. GAAP:


	As of December 31,
	2022		2021
Foreign Currency	(in millions)
Euro	$	1,497.7	$	1,364.5
British pound sterling	247.4		287.7
Canadian dollar	216.3		89.9
Australian dollar	174.9		96.3
Swiss Franc	65.2		54.1
Total foreign currency forward contracts	$	2,201.5	$	1,892.5

Schedule of Foreign Exchange Contracts, Condensed Consolidated Statements of Operations

During the three years ended December 31, 2022, we recognized the following related to foreign currency forward contracts in our consolidated statements of operations:


	December 31,
	2022		2021		2020
	(in millions)
Designated as hedging instruments - Reclassified from AOCI
Product revenues, net	$	182.5	$	(30.0)	$	(3.7)
Not designated as hedging instruments
Other (expense) income, net	$	(9.9)	$	(18.6)	$	22.1

Total reported in the Consolidated Statements of Operations
Product revenues, net	$	8,930.7	$	7,573.4	$	6,202.8
Other (expense) income, net	$	(164.8)	$	4.9	$	296.6

Schedule of Foreign Exchange Contracts

The following table summarizes the fair value of our outstanding foreign currency forward contracts designated as cash flow hedges under U.S. GAAP included on our consolidated balance sheets:


As of December 31, 2022
Assets			Liabilities
Classification	Fair Value		Classification	Fair Value
(in millions)
Prepaid expenses and other current assets	$	47.5	Other current liabilities	$	(14.3)
Other assets	0.8		Other long-term liabilities	(0.9)
Total assets	$	48.3	Total liabilities	$	(15.2)


As of December 31, 2021
Assets			Liabilities
Classification	Fair Value		Classification	Fair Value
(in millions)
Prepaid expenses and other current assets	$	44.5	Other current liabilities	$	(5.6)
Other assets	2.0		Other long-term liabilities	(2.7)
Total assets	$	46.5	Total liabilities	$	(8.3)

Schedule of Offsetting Liabilities

The following table summarizes the potential effect of offsetting derivatives by type of financial instrument designated as cash flow hedges under U.S. GAAP on our consolidated balance sheets:


	As of December 31, 2022
	Gross Amounts Recognized		Gross Amounts Offset		Gross Amounts Presented		Gross Amounts Not Offset		Legal Offset
Foreign currency forward contracts	(in millions)
Total assets	$	48.3	$	—	$	48.3	$	(15.2)	$	33.1
Total liabilities	(15.2)		—		(15.2)		15.2		—


	As of December 31, 2021
	Gross Amounts Recognized		Gross Amounts Offset		Gross Amounts Presented		Gross Amounts Not Offset		Legal Offset
Foreign currency forward contracts	(in millions)
Total assets	$	46.5	$	—	$	46.5	$	(8.3)	$	38.2
Total liabilities	(8.3)		—		(8.3)		8.3		—

Schedule of Offsetting Assets

The following table summarizes the potential effect of offsetting derivatives by type of financial instrument designated as cash flow hedges under U.S. GAAP on our consolidated balance sheets:


	As of December 31, 2022
	Gross Amounts Recognized		Gross Amounts Offset		Gross Amounts Presented		Gross Amounts Not Offset		Legal Offset
Foreign currency forward contracts	(in millions)
Total assets	$	48.3	$	—	$	48.3	$	(15.2)	$	33.1
Total liabilities	(15.2)		—		(15.2)		15.2		—


	As of December 31, 2021
	Gross Amounts Recognized		Gross Amounts Offset		Gross Amounts Presented		Gross Amounts Not Offset		Legal Offset
Foreign currency forward contracts	(in millions)
Total assets	$	46.5	$	—	$	46.5	$	(8.3)	$	38.2
Total liabilities	(8.3)		—		(8.3)		8.3		—

Income Taxes - Deferred Tax Assets and Liabilities (Details) - USD ($) $ in Millions	Dec. 31, 2022	Dec. 31, 2021
Deferred tax assets:
Net operating loss	$ 77.4	$ 106.6
Tax credit carryforwards	223.0	202.4
Intangible assets	738.5	802.8
Stock-based compensation	124.4	94.6
Finance lease liabilities	94.9	103.4
Operating lease assets	79.6	81.1
R&D capitalization	438.3	0.0
Other	69.2	90.3
Gross deferred tax assets	1,845.3	1,481.2
Valuation allowance	(237.8)	(220.4)
Total deferred tax assets	1,607.5	1,260.8
Deferred tax liabilities:
Property and equipment	(139.8)	(118.2)
Acquired intangibles	(130.5)	(87.0)
Operating lease liabilities	(63.1)	(64.8)
Other	(27.2)	(56.3)
Total deferred tax liabilities	(360.6)	(326.3)
Net deferred tax assets	$ 1,246.9	$ 934.5

Accumulated Other Comprehensive Income (Loss) (Tables)

12 Months Ended

Dec. 31, 2022

Equity [Abstract]

Schedule of Accumulated Other Comprehensive Income (Loss)

The following table summarizes the changes in accumulated other comprehensive income (loss) by component:


			Unrealized Holding Gains (Losses), Net of Tax
	Foreign Currency Translation Adjustment		On Available-For-Sale Debt Securities		On Foreign Currency Forward Contracts		Total
	(in millions)
Balance as of December 31, 2019	$	(0.9)	$	0.5	$	(1.6)	$	(2.0)
Other comprehensive loss before reclassifications	(14.7)		(0.2)		(54.5)		(69.4)
Amounts reclassified from accumulated other comprehensive income (loss)	—		—		2.9		2.9
Net current period other comprehensive loss	(14.7)		(0.2)		(51.6)		(66.5)
Balance as of December 31, 2020	$	(15.6)	$	0.3	$	(53.2)	$	(68.5)
Other comprehensive income (loss) before reclassifications	2.0		(0.8)		59.7		60.9
Amounts reclassified from accumulated other comprehensive income (loss)	—		—		23.5		23.5
Net current period other comprehensive income (loss)	2.0		(0.8)		83.2		84.4
Balance as of December 31, 2021	$	(13.6)	$	(0.5)	$	30.0	$	15.9
Other comprehensive (loss) income before reclassifications	(11.4)		(3.3)		138.9		124.2
Amounts reclassified from accumulated other comprehensive income (loss)	—		3.7		(143.0)		(139.3)
Net current period other comprehensive (loss) income	(11.4)		0.4		(4.1)		(15.1)
Balance as of December 31, 2022	$	(25.0)	$	(0.1)	$	25.9	$	0.8

Segment Information - Significant Customers (Details)	12 Months Ended
Segment Information - Significant Customers (Details)	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Product Concentration Risk \| Percent of Total Gross Product Revenues \| McKesson Corporation
Concentration Risk [Line Items]
Concentration risk percentage	25.00%	22.00%	20.00%
Product Concentration Risk \| Percent of Total Gross Product Revenues \| Accredo Health Group, Inc.
Concentration Risk [Line Items]
Concentration risk percentage	12.00%	12.00%	15.00%
Product Concentration Risk \| Percent of Total Gross Product Revenues \| Walgreen Co.
Concentration Risk [Line Items]
Concentration risk percentage	10.00%	10.00%	14.00%
Product Concentration Risk \| Percent of Total Gross Product Revenues \| Lloyds Pharmacy
Concentration Risk [Line Items]
Concentration risk percentage	10.00%	10.00%	10.00%
Credit Concentration Risk \| Percent of Accounts Receivable \| McKesson Corporation
Concentration Risk [Line Items]
Concentration risk percentage	22.00%	21.00%
Credit Concentration Risk \| Percent of Accounts Receivable \| Accredo Health Group, Inc.
Concentration Risk [Line Items]
Concentration risk percentage	10.00%	10.00%
Credit Concentration Risk \| Percent of Accounts Receivable \| Walgreen Co.
Concentration Risk [Line Items]
Concentration risk percentage	10.00%	10.00%
Credit Concentration Risk \| Percent of Accounts Receivable \| Lloyds Pharmacy
Concentration Risk [Line Items]
Concentration risk percentage	12.00%	15.00%

Common Stock, Preferred Stock and Equity Plans - Stock Options Outstanding and Exercisable (Details) shares in Thousands	12 Months Ended
	Dec. 31, 2022 $ / shares shares
Stock options outstanding and exercisable
Options outstanding (in shares) \| shares	2,527
Options outstanding, weighted-average remaining contractual life	4 years 8 months 1 day
Options outstanding, weighted-average exercise price (in dollars per share)	$ 146.11
Options exercisable (in shares) \| shares	2,446
Options exercisable, weighted-average exercise price (in dollars per share)	$ 144.94
$45.11–$100.00
Stock options outstanding and exercisable
Exercise price, low end of range (in dollars per share)	45.11
Exercise price, high end of range (in dollars per share)	$ 100.00
Options outstanding (in shares) \| shares	689
Options outstanding, weighted-average remaining contractual life	3 years 1 month 17 days
Options outstanding, weighted-average exercise price (in dollars per share)	$ 86.05
Options exercisable (in shares) \| shares	689
Options exercisable, weighted-average exercise price (in dollars per share)	$ 86.05
$100.01–$150.00
Stock options outstanding and exercisable
Exercise price, low end of range (in dollars per share)	100.01
Exercise price, high end of range (in dollars per share)	$ 150.00
Options outstanding (in shares) \| shares	286
Options outstanding, weighted-average remaining contractual life	2 years 6 months 29 days
Options outstanding, weighted-average exercise price (in dollars per share)	$ 123.17
Options exercisable (in shares) \| shares	286
Options exercisable, weighted-average exercise price (in dollars per share)	$ 123.17
$150.01–$200.00
Stock options outstanding and exercisable
Exercise price, low end of range (in dollars per share)	150.01
Exercise price, high end of range (in dollars per share)	$ 200.00
Options outstanding (in shares) \| shares	1,482
Options outstanding, weighted-average remaining contractual life	5 years 7 months 9 days
Options outstanding, weighted-average exercise price (in dollars per share)	$ 173.26
Options exercisable (in shares) \| shares	1,401
Options exercisable, weighted-average exercise price (in dollars per share)	$ 172.78
$200.01–$286.27
Stock options outstanding and exercisable
Exercise price, low end of range (in dollars per share)	200.01
Exercise price, high end of range (in dollars per share)	$ 286.27
Options outstanding (in shares) \| shares	70
Options outstanding, weighted-average remaining contractual life	8 years 3 months 29 days
Options outstanding, weighted-average exercise price (in dollars per share)	$ 256.44
Options exercisable (in shares) \| shares	70
Options exercisable, weighted-average exercise price (in dollars per share)	$ 256.44

Consolidated Statements of Shareholders’ Equity - USD ($) $ in Millions	Total	Common Stock	Additional Paid-in Capital	Accumulated Other Comprehensive Income (Loss)	Retained Earnings (Accumulated Deficit)
Beginning balance (in shares) at Dec. 31, 2019		259,000,000.0
Beginning balance at Dec. 31, 2019	$ 6,085.2	$ 2.6	$ 7,937.6	$ (2.0)	$ (1,853.0)
Increase (Decrease) in Stockholders' Equity
Other comprehensive income (loss), net of tax	(66.5)			(66.5)
Net income	2,711.7				2,711.7
Repurchases of common stock (in shares)		(2,400,000)
Repurchases of common stock	(539.1)	$ (0.0)	(539.1)
Common stock withheld for employee tax obligations (in shares)		(800,000)
Common stock withheld for employee tax obligations	(200.3)	$ (0.0)	(200.3)
Issuance of common stock under benefit plans (in shares)		4,100,000
Issuance of common stock under benefit plans	262.7	$ 0.0	262.7
Stock-based compensation expense	433.1		433.1
Ending balance (in shares) at Dec. 31, 2020		259,900,000
Ending balance at Dec. 31, 2020	8,686.8	$ 2.6	7,894.0	(68.5)	858.7
Increase (Decrease) in Stockholders' Equity
Other comprehensive income (loss), net of tax	84.4			84.4
Net income	2,342.1				2,342.1
Repurchases of common stock (in shares)		(7,300,000)
Repurchases of common stock	(1,425.4)	$ (0.1)	(1,425.3)
Common stock withheld for employee tax obligations (in shares)		(600,000)
Common stock withheld for employee tax obligations	(135.9)	$ (0.0)	(135.9)
Issuance of common stock under benefit plans (in shares)		2,500,000
Issuance of common stock under benefit plans	102.5	$ 0.0	102.5
Stock-based compensation expense	$ 445.5		445.5
Ending balance (in shares) at Dec. 31, 2021	254,479,046	254,500,000
Ending balance at Dec. 31, 2021	$ 10,100.0	$ 2.5	6,880.8	15.9	3,200.8
Increase (Decrease) in Stockholders' Equity
Other comprehensive income (loss), net of tax	(15.1)			(15.1)
Net income	3,322.0				3,322.0
Common stock withheld for employee tax obligations (in shares)		(700,000)
Common stock withheld for employee tax obligations	(172.0)	$ (0.0)	(172.0)
Issuance of common stock under benefit plans (in shares)		3,200,000
Issuance of common stock under benefit plans	187.4	$ 0.1	187.3
Stock-based compensation expense	$ 490.4		490.4
Ending balance (in shares) at Dec. 31, 2022	257,011,628	257,000,000.0
Ending balance at Dec. 31, 2022	$ 13,912.7	$ 2.6	$ 7,386.5	$ 0.8	$ 6,522.8

Common Stock, Preferred Stock and Equity Plans - Share Repurchase Program (Details) - USD ($) shares in Millions	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Feb. 10, 2023	Dec. 31, 2022	Jun. 30, 2021	Nov. 30, 2020	Jul. 31, 2019
Equity, Class of Treasury Stock [Line Items]
Repurchases of common stock	$ 1,425,400,000	$ 539,100,000
Share Repurchase Program 2019
Equity, Class of Treasury Stock [Line Items]
Number of shares authorized to be repurchased							$ 500,000,000
Repurchases of common stock (in shares)		2.1
Repurchases of common stock		$ 464,000,000
Share Repurchase Program 2020
Equity, Class of Treasury Stock [Line Items]
Number of shares authorized to be repurchased						$ 500,000,000
Repurchases of common stock (in shares)	2.0	0.3
Repurchases of common stock	$ 424,900,000	$ 75,100,000
Share Repurchase Program 2021
Equity, Class of Treasury Stock [Line Items]
Number of shares authorized to be repurchased					$ 1,500,000,000
Repurchases of common stock (in shares)	5.3
Repurchases of common stock	$ 1,000,000,000
Number of shares remaining for repurchases				$ 499,700,000
Share Repurchase Program 2023 \| Subsequent Event
Equity, Class of Treasury Stock [Line Items]
Number of shares authorized to be repurchased			$ 3,000,000,000

Property and Equipment - Property and Equipment, Net (Details) - USD ($) $ in Millions	Dec. 31, 2022	Dec. 31, 2021
Property, Plant and Equipment [Line Items]
Total property and equipment, gross	$ 2,135.7	$ 1,990.1
Less: accumulated depreciation	(1,027.3)	(896.0)
Total property and equipment, net	1,108.4	1,094.1
Buildings and improvements
Property, Plant and Equipment [Line Items]
Total property and equipment, gross	903.1	892.5
Laboratory equipment, other equipment and furniture
Property, Plant and Equipment [Line Items]
Total property and equipment, gross	476.5	407.3
Leasehold improvements
Property, Plant and Equipment [Line Items]
Total property and equipment, gross	410.9	363.5
Computers and software
Property, Plant and Equipment [Line Items]
Total property and equipment, gross	312.1	293.7
Land
Property, Plant and Equipment [Line Items]
Total property and equipment, gross	$ 33.1	$ 33.1

Leases - Maturities of Operating and Financing Lease Liabilities (Details) - USD ($) $ in Millions	Dec. 31, 2022	Dec. 31, 2021
Finance Leases
2023	$ 76.0
2024	88.7
2025	89.0
2026	89.3
2027	89.7
Thereafter	233.6
Total lease payments	666.3
Less: amount representing interest	(194.7)
Present value of lease liabilities	471.6	$ 556.7
Operating Leases
2023	58.4
2024	44.3
2025	40.2
2026	39.4
2027	35.3
Thereafter	273.7
Total lease payments	491.3
Less: amount representing interest	(63.2)
Present value of lease liabilities	428.1	$ 410.7
Total
2023	134.4
2024	133.0
2025	129.2
2026	128.7
2027	125.0
Thereafter	507.3
Total lease payments	1,157.6
Less: amount representing interest	(257.9)
Present value of lease liabilities	$ 899.7

Fair Value Measurements - Financial Assets and Liabilities Subject to Fair Value Measurements (Details) - USD ($) $ in Millions	Dec. 31, 2022	Dec. 31, 2021
Financial instruments carried at fair value (asset positions):
Derivative Asset, Current, Statement of Financial Position [Extensible Enumeration]	Prepaid expenses and other current assets	Prepaid expenses and other current assets
Derivative Asset, Noncurrent, Statement of Financial Position [Extensible Enumeration]	Other assets	Other assets
Financial instruments carried at fair value (liability positions):
Other long-term liabilities, contingent consideration	$ (114.4)	$ (186.5)
Derivative Liability, Current, Statement of Financial Position [Extensible Enumeration]	Other current liabilities	Other current liabilities
Derivative Liability, Noncurrent, Statement of Financial Position [Extensible Enumeration]	Other Liabilities, Noncurrent	Other Liabilities, Noncurrent
Recurring basis
Financial instruments carried at fair value (asset positions):
Derivative asset current, foreign currency forward contracts	$ 47.5	$ 44.5
Other assets, foreign currency forward contracts	0.8	2.0
Total financial assets	7,807.9	4,254.5
Financial instruments carried at fair value (liability positions):
Other current liabilities, foreign currency forward contracts	(14.3)	(5.6)
Other current liabilities, contingent consideration	(14.6)	0.0
Other long-term liabilities, foreign currency forward contracts	(0.9)	(2.7)
Other long-term liabilities, contingent consideration	(114.4)	(186.5)
Total financial liabilities	(144.2)	(194.8)
Recurring basis \| Level 1
Financial instruments carried at fair value (asset positions):
Derivative asset current, foreign currency forward contracts	0.0	0.0
Other assets, foreign currency forward contracts	0.0	0.0
Total financial assets	5,378.5	3,864.4
Financial instruments carried at fair value (liability positions):
Other current liabilities, foreign currency forward contracts	0.0	0.0
Other current liabilities, contingent consideration	0.0	0.0
Other long-term liabilities, foreign currency forward contracts	0.0	0.0
Other long-term liabilities, contingent consideration	0.0	0.0
Total financial liabilities	0.0	0.0
Recurring basis \| Level 2
Financial instruments carried at fair value (asset positions):
Derivative asset current, foreign currency forward contracts	47.5	44.5
Other assets, foreign currency forward contracts	0.8	2.0
Total financial assets	2,429.4	390.1
Financial instruments carried at fair value (liability positions):
Other current liabilities, foreign currency forward contracts	(14.3)	(5.6)
Other current liabilities, contingent consideration	0.0	0.0
Other long-term liabilities, foreign currency forward contracts	(0.9)	(2.7)
Other long-term liabilities, contingent consideration	0.0	0.0
Total financial liabilities	(15.2)	(8.3)
Recurring basis \| Level 3
Financial instruments carried at fair value (asset positions):
Derivative asset current, foreign currency forward contracts	0.0	0.0
Other assets, foreign currency forward contracts	0.0	0.0
Total financial assets	0.0	0.0
Financial instruments carried at fair value (liability positions):
Other current liabilities, foreign currency forward contracts	0.0	0.0
Other current liabilities, contingent consideration	(14.6)	0.0
Other long-term liabilities, foreign currency forward contracts	0.0	0.0
Other long-term liabilities, contingent consideration	(114.4)	(186.5)
Total financial liabilities	(129.0)	(186.5)
Recurring basis \| Money market funds
Financial instruments carried at fair value (asset positions):
Cash equivalents:	5,162.6	3,478.1
Recurring basis \| Money market funds \| Level 1
Financial instruments carried at fair value (asset positions):
Cash equivalents:	5,162.6	3,478.1
Recurring basis \| Money market funds \| Level 2
Financial instruments carried at fair value (asset positions):
Cash equivalents:	0.0	0.0
Recurring basis \| Money market funds \| Level 3
Financial instruments carried at fair value (asset positions):
Cash equivalents:	0.0	0.0
Recurring basis \| Time deposits
Financial instruments carried at fair value (asset positions):
Cash equivalents:	2,000.0	0.0
Recurring basis \| Time deposits \| Level 1
Financial instruments carried at fair value (asset positions):
Cash equivalents:	0.0	0.0
Recurring basis \| Time deposits \| Level 2
Financial instruments carried at fair value (asset positions):
Cash equivalents:	2,000.0	0.0
Recurring basis \| Time deposits \| Level 3
Financial instruments carried at fair value (asset positions):
Cash equivalents:	0.0	0.0
Recurring basis \| Corporate debt securities
Financial instruments carried at fair value (asset positions):
Cash equivalents:	5.8	0.0
Marketable securities:	87.0	90.9
Recurring basis \| Corporate debt securities \| Level 1
Financial instruments carried at fair value (asset positions):
Cash equivalents:	0.0	0.0
Marketable securities:	0.0	0.0
Recurring basis \| Corporate debt securities \| Level 2
Financial instruments carried at fair value (asset positions):
Cash equivalents:	5.8	0.0
Marketable securities:	87.0	90.9
Recurring basis \| Corporate debt securities \| Level 3
Financial instruments carried at fair value (asset positions):
Cash equivalents:	0.0	0.0
Marketable securities:	0.0	0.0
Recurring basis \| Commercial paper
Financial instruments carried at fair value (asset positions):
Cash equivalents:	204.5	0.0
Marketable securities:	55.8	252.7
Recurring basis \| Commercial paper \| Level 1
Financial instruments carried at fair value (asset positions):
Cash equivalents:	0.0	0.0
Marketable securities:	0.0	0.0
Recurring basis \| Commercial paper \| Level 2
Financial instruments carried at fair value (asset positions):
Cash equivalents:	204.5	0.0
Marketable securities:	55.8	252.7
Recurring basis \| Commercial paper \| Level 3
Financial instruments carried at fair value (asset positions):
Cash equivalents:	0.0	0.0
Marketable securities:	0.0	0.0
Recurring basis \| Corporate equity securities
Financial instruments carried at fair value (asset positions):
Marketable securities:	116.8	230.9
Recurring basis \| Corporate equity securities \| Level 1
Financial instruments carried at fair value (asset positions):
Marketable securities:	88.8	230.9
Recurring basis \| Corporate equity securities \| Level 2
Financial instruments carried at fair value (asset positions):
Marketable securities:	28.0	0.0
Recurring basis \| Corporate equity securities \| Level 3
Financial instruments carried at fair value (asset positions):
Marketable securities:	0.0	0.0
Recurring basis \| U.S. Treasury securities
Financial instruments carried at fair value (asset positions):
Marketable securities:	0.0	86.4
Recurring basis \| U.S. Treasury securities \| Level 1
Financial instruments carried at fair value (asset positions):
Marketable securities:	0.0	86.4
Recurring basis \| U.S. Treasury securities \| Level 2
Financial instruments carried at fair value (asset positions):
Marketable securities:	0.0	0.0
Recurring basis \| U.S. Treasury securities \| Level 3
Financial instruments carried at fair value (asset positions):
Marketable securities:	0.0	0.0
Recurring basis \| Government-sponsored enterprise securities
Financial instruments carried at fair value (asset positions):
Marketable securities:	127.1	69.0
Recurring basis \| Government-sponsored enterprise securities \| Level 1
Financial instruments carried at fair value (asset positions):
Marketable securities:	127.1	69.0
Recurring basis \| Government-sponsored enterprise securities \| Level 2
Financial instruments carried at fair value (asset positions):
Marketable securities:	0.0	0.0
Recurring basis \| Government-sponsored enterprise securities \| Level 3
Financial instruments carried at fair value (asset positions):
Marketable securities:	$ 0.0	$ 0.0

Consolidated Statements of Comprehensive Income - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Statement of Comprehensive Income [Abstract]
Net income	$ 3,322.0	$ 2,342.1	$ 2,711.7
Other comprehensive (loss) income:
Unrealized holding gains (losses) on marketable securities, net	0.4	(0.8)	(0.2)
Unrealized (losses) gains on foreign currency forward contracts, net of tax of $1.0, $(21.8) and $14.3, respectively	(4.1)	83.2	(51.6)
Foreign currency translation adjustment	(11.4)	2.0	(14.7)
Total other comprehensive (loss) income	(15.1)	84.4	(66.5)
Comprehensive income	$ 3,306.9	$ 2,426.5	$ 2,645.2

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 942
-SubTopic 220
-Section S99
-Paragraph 1
-Subparagraph (SX 210.9-04(22))
-URI https://asc.fasb.org/extlink&oid=120399700&loc=SL114874048-224260

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (f)
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8933-108599

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 250
-SubTopic 10
-Section 50
-Paragraph 4
-URI https://asc.fasb.org/extlink&oid=124431687&loc=d3e22595-107794

Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 220
-Section S99
-Paragraph 1
-Subparagraph (SX 210.7-04(18))
-URI https://asc.fasb.org/extlink&oid=120400993&loc=SL114874131-224263

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 815
-SubTopic 40
-Section 65
-Paragraph 1
-Subparagraph (f)
-URI https://asc.fasb.org/extlink&oid=126732423&loc=SL123482106-238011

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 220
-SubTopic 10
-Section 50
-Paragraph 6
-URI https://asc.fasb.org/extlink&oid=124431353&loc=SL124452729-227067

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1B
-Subparagraph (SX 210.13-02(a)(5))
-URI https://asc.fasb.org/extlink&oid=126975872&loc=SL124442552-122756

Reference 8: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 220
-SubTopic 10
-Section S99
-Paragraph 2
-Subparagraph (SX 210.5-03(20))
-URI https://asc.fasb.org/extlink&oid=126953954&loc=SL114868664-224227

Reference 9: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 230
-SubTopic 10
-Section 45
-Paragraph 28
-URI https://asc.fasb.org/extlink&oid=126954810&loc=d3e3602-108585

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 250
-SubTopic 10
-Section 50
-Paragraph 1
-Subparagraph (b)(2)
-URI https://asc.fasb.org/extlink&oid=124431687&loc=d3e22499-107794

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1A
-Subparagraph (SX 210.13-01(a)(4)(iv))
-URI https://asc.fasb.org/extlink&oid=126975872&loc=SL124442526-122756

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1A
-Subparagraph (SX 210.13-01(a)(4)(iii)(A))
-URI https://asc.fasb.org/extlink&oid=126975872&loc=SL124442526-122756

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1B
-Subparagraph (SX 210.13-02(a)(4)(i))
-URI https://asc.fasb.org/extlink&oid=126975872&loc=SL124442552-122756

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1A
-Subparagraph (SX 210.13-01(a)(4)(i))
-URI https://asc.fasb.org/extlink&oid=126975872&loc=SL124442526-122756

Reference 15: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 250
-SubTopic 10
-Section 50
-Paragraph 9
-URI https://asc.fasb.org/extlink&oid=124431687&loc=d3e22663-107794

Reference 16: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1B
-Subparagraph (SX 210.13-02(a)(4)(iv))
-URI https://asc.fasb.org/extlink&oid=126975872&loc=SL124442552-122756

Reference 17: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1A
-Subparagraph (SX 210.13-01(a)(4)(ii))
-URI https://asc.fasb.org/extlink&oid=126975872&loc=SL124442526-122756

Reference 18: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 825
-SubTopic 10
-Section 50
-Paragraph 28
-Subparagraph (f)
-URI https://asc.fasb.org/extlink&oid=123596393&loc=d3e14064-108612

Reference 19: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 250
-SubTopic 10
-Section 50
-Paragraph 3
-URI https://asc.fasb.org/extlink&oid=124431687&loc=d3e22583-107794

Reference 20: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 235
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(g)(1)(ii))
-URI https://asc.fasb.org/extlink&oid=120395691&loc=d3e23780-122690

Reference 21: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 260
-SubTopic 10
-Section 45
-Paragraph 60B
-Subparagraph (a)
-URI https://asc.fasb.org/extlink&oid=126958026&loc=SL5780133-109256

Reference 22: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 323
-SubTopic 10
-Section 50
-Paragraph 3
-Subparagraph (c)
-URI https://asc.fasb.org/extlink&oid=114001798&loc=d3e33918-111571

Reference 23: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 250
-SubTopic 10
-Section 50
-Paragraph 8
-URI https://asc.fasb.org/extlink&oid=124431687&loc=d3e22658-107794

Reference 24: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 220
-SubTopic 10
-Section 45
-Paragraph 1A
-Subparagraph (a)
-URI https://asc.fasb.org/extlink&oid=126968391&loc=SL7669619-108580

Reference 25: http://www.xbrl.org/2003/role/exampleRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 31
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8924-108599

Reference 26: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 250
-SubTopic 10
-Section 50
-Paragraph 11
-Subparagraph (b)
-URI https://asc.fasb.org/extlink&oid=124431687&loc=d3e22694-107794

Reference 27: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 250
-SubTopic 10
-Section 50
-Paragraph 11
-Subparagraph (a)
-URI https://asc.fasb.org/extlink&oid=124431687&loc=d3e22694-107794

Reference 28: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 50
-Paragraph 7
-URI https://asc.fasb.org/extlink&oid=109222650&loc=SL51721683-107760

Reference 29: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 220
-SubTopic 10
-Section 45
-Paragraph 1B
-Subparagraph (a)
-URI https://asc.fasb.org/extlink&oid=126968391&loc=SL7669625-108580

Reference 30: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 22
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8736-108599

Reference 31: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1A
-Subparagraph (SX 210.13-01(a)(5))
-URI https://asc.fasb.org/extlink&oid=126975872&loc=SL124442526-122756

Reference 32: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1B
-Subparagraph (SX 210.13-02(a)(4)(iii)(B))
-URI https://asc.fasb.org/extlink&oid=126975872&loc=SL124442552-122756

Reference 33: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1B
-Subparagraph (SX 210.13-02(a)(4)(iii)(A))
-URI https://asc.fasb.org/extlink&oid=126975872&loc=SL124442552-122756

Reference 34: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 30
-Subparagraph (b)
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8906-108599

Reference 35: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (c)
-URI https://asc.fasb.org/extlink&oid=126901519&loc=d3e8933-108599

+ Details

Nature of Business and Accounting Policies

12 Months Ended

Dec. 31, 2022

Accounting Policies [Abstract]

Nature of Business and Accounting Policies

Business

Vertex Pharmaceuticals Incorporated (“Vertex,” “we,” “us” or “our”) is a global biotechnology company that invests in scientific innovation to create transformative medicines for people with serious diseases, with a focus on specialty markets. We have four approved medicines that treat the underlying cause of cystic fibrosis (“CF”), a life-threatening genetic disease, and we continue to focus on developing additional treatments for CF. Beyond CF, we have a pipeline that includes mid- and late-stage clinical programs in sickle cell disease, beta thalassemia, acute and neuropathic pain, APOL1-mediated kidney disease, type 1 diabetes, and alpha-1 antitrypsin deficiency, and earlier-stage programs in diseases such as muscular dystrophies.

Our marketed CF medicines are TRIKAFTA/KAFTRIO (elexacaftor/tezacaftor/ivacaftor and ivacaftor), SYMDEKO/SYMKEVI (tezacaftor/ivacaftor and ivacaftor), ORKAMBI (lumacaftor/ivacaftor) and KALYDECO (ivacaftor).

Basis of Presentation

Use of Estimates

Revenue Recognition

when that performance obligation is satisfied or as it is satisfied. Generally, our performance obligations are transferred to customers at a point in time, typically upon delivery.

Product Revenues, Net

We exclude taxes collected from customers relating to product sales and remitted to governmental authorities from revenues.

Contract Liabilities

Concentration of Credit Risk

Cash and Cash Equivalents

We consider all highly liquid investments with original maturities of three months or less at the date of purchase to be cash equivalents.

Marketable Securities

Accounts Receivable

We deduct invoice discounts for prompt payment and fees for distribution services from our accounts receivable based on our experience that our customers will earn these discounts and fees. Our estimates for our allowance for credit losses, which has not been significant to date, is determined based on existing contractual payment terms, historical payment patterns, current economic conditions and our expectation for future economic conditions.

Stock-based Compensation Expense

Please refer to Note O, “Stock-based Compensation Expense,” for tables displaying our stock-based compensation expense by type of award and by line item within our consolidated statements of operations.

Research and Development Expenses

Acquired In-process Research and Development Expenses

Inventories

Property and Equipment


Description						Estimated Useful Life
Buildings and improvements						15 to 40 years
Laboratory equipment, other equipment and furniture						7 to 10 years
Leasehold improvements; assets under finance leases						The shorter of the useful life of the assets or the estimated remaining term of the associated lease
Computers and software						3 to 5 years

Cloud Computing Service Contracts

Leases

Income Taxes

Our provision for income taxes is accounted for under the asset and liability method and includes federal, state, local and foreign taxes.

As part of the U.S. Tax Cut and Jobs Act of 2017, we are subject to a territorial tax system, under which we must

Variable Interest Entities

Fair Value of In-process Research and Development Assets and Contingent Payments

In-process Research and Development Assets

Goodwill

The difference between the purchase price and the fair value of assets acquired and liabilities assumed in a business combination is allocated to goodwill. Goodwill is evaluated for impairment on an annual basis as of October 1, and more frequently if indicators are present or changes in circumstances suggest that impairment may exist. As noted in Basis of Presentation above, we have one operating segment, pharmaceuticals, which is our only reporting unit.

Hedging Activities

Comprehensive Income

Foreign Currency Translation and Transactions

The majority of our operations occur in entities that have the U.S. dollar denominated as their functional currency. The assets and liabilities of our entities with functional currencies other than the U.S. dollar are translated into U.S. dollars at exchange rates in effect at the end of the year. Revenue and expense amounts for these entities are translated using the average exchange rates for the period. Changes resulting from foreign currency translation are included in “Accumulated other comprehensive income.” Net foreign currency exchange transaction losses, which are included in “Other (expense) income, net” on our consolidated statements of operations, were $15.1 million, $13.9 million and $16.1 million for 2022, 2021 and 2020, respectively. These net foreign currency exchange losses are presented net of the impact of the foreign currency forward contracts designed to mitigate their effect on our consolidated statements of operations.

Share Repurchase Programs

Net Income Per Common Share

Recently Adopted and Issued Accounting Standards

Leases

12 Months Ended

Dec. 31, 2022

Leases [Abstract]

Leases

Finance Leases

Our finance lease assets and liabilities primarily relate to our corporate headquarters in Boston and research site in San Diego (the “Buildings”). These Buildings are classified as finance leases because the present value of the sum of the lease payments associated with the Buildings exceeds substantially all of the fair value of the Buildings. We also have an outstanding finance lease for land.

Corporate Headquarters

In 2011, we entered into two lease agreements, pursuant to which we lease approximately 1.1 million square feet of office and laboratory space in two buildings in Boston, Massachusetts for a term of 15 years. Base rent payments commenced in 2013 and will continue through December 2028. We utilize this initial period as our lease term. We have an option to extend the lease term for an additional ten years.

San Diego Lease

In 2015, we entered into a lease agreement pursuant to which we lease approximately 170,000 square feet of office and laboratory space in San Diego, California for a term of 16 years. Base rent payments commenced in 2019 and will continue through May 2034. We utilize this initial period as our lease term. We have an option to extend the lease term for up to two additional five-year terms.

Operating Leases

Our operating leases relate to our real estate leases that are not classified as finance leases.

Jeffrey Leiden Center for Cell and Genetic Therapies

In 2019, we entered into an agreement to lease approximately 269,000 square feet of office and laboratory space near our corporate headquarters in Boston, Massachusetts for a term of 16 years. Base rent payments commenced in 2021 and will

continue through November 2036. We utilize the initial period as our lease term. We have an option to extend the lease term for up to two additional ten-year periods.

Please refer to our accounting policy, Leases, in Note A, “Nature of Business and Accounting Policies,” for further information on the accounting treatment for our finance and operating leases.

Aggregate Lease Information

The components of lease cost recorded in our consolidated statements of operations were as follows:


	2022		2021		2020
	(in millions)
Operating lease cost	$	35.3	$	33.9	$	23.1
Finance lease cost
Amortization of leased assets	51.0		51.9		51.2
Interest on lease liabilities	43.5		47.4		50.2
Variable lease cost	39.8		33.6		30.8
Sublease income	(2.7)		(0.4)		(4.0)
Net lease cost	$	166.9	$	166.4	$	151.3

Our variable lease cost during 2022, 2021 and 2020 primarily related to operating expenses, taxes and insurance associated with our finance leases.

Our leases are included on our consolidated balance sheets as follows:


	As of December 31,
	2022		2021
	(in millions)
Finance leases
Property and equipment, net	$	315.5	$	400.1
Total finance lease assets	$	315.5	$	400.1

Other current liabilities	$	40.8	$	46.9
Long-term finance lease liabilities	430.8		509.8
Total finance lease liabilities	$	471.6	$	556.7

Operating leases
Operating lease assets	$	347.4	$	330.3
Total operating lease assets	$	347.4	$	330.3

Other current liabilities	$	48.6	$	33.3
Long-term operating lease liabilities	379.5		377.4
Total operating lease liabilities	$	428.1	$	410.7

Maturities of our finance and operating lease liabilities as of December 31, 2022 were as follows:


Year	Finance Leases		Operating Leases		Total
	(in millions)
2023	$	76.0	$	58.4	$	134.4
2024	88.7		44.3		133.0
2025	89.0		40.2		129.2
2026	89.3		39.4		128.7
2027	89.7		35.3		125.0
Thereafter	233.6		273.7		507.3
Total lease payments	666.3		491.3		1,157.6
Less: amount representing interest	(194.7)		(63.2)		(257.9)
Present value of lease liabilities	$	471.6	$	428.1	$	899.7

The weighted-average remaining lease terms and discount rates related to our leases were as follows:


	As of December 31,
	2022		2021
Weighted-average remaining lease term (in years)
Finance leases	10.60		10.73
Operating leases	11.57		12.81

Weighted-average discount rate
Finance leases	8.36	%	8.11	%
Operating leases	2.46	%	2.19	%

Supplemental cash flow information related to our leases was as follows:


	2022		2021		2020
	(in millions)
Cash paid for amounts included in the measurement of lease liabilities
Operating cash flows from operating leases	$	50.8	$	21.5	$	16.3
Operating cash flows from finance leases	$	42.5	$	46.2	$	48.9
Financing cash flows from finance leases	$	85.5	$	47.0	$	42.3

Right-of-use assets obtained in exchange for lease obligations
Operating leases	$	58.6	$	36.3	$	293.6
Finance leases	$	—	$	—	$	33.1

Leases

Finance Leases

Corporate Headquarters

San Diego Lease

Operating Leases

Our operating leases relate to our real estate leases that are not classified as finance leases.

Jeffrey Leiden Center for Cell and Genetic Therapies

continue through November 2036. We utilize the initial period as our lease term. We have an option to extend the lease term for up to two additional ten-year periods.

Please refer to our accounting policy, Leases, in Note A, “Nature of Business and Accounting Policies,” for further information on the accounting treatment for our finance and operating leases.

Aggregate Lease Information

The components of lease cost recorded in our consolidated statements of operations were as follows:


	2022		2021		2020
	(in millions)
Operating lease cost	$	35.3	$	33.9	$	23.1
Finance lease cost
Amortization of leased assets	51.0		51.9		51.2
Interest on lease liabilities	43.5		47.4		50.2
Variable lease cost	39.8		33.6		30.8
Sublease income	(2.7)		(0.4)		(4.0)
Net lease cost	$	166.9	$	166.4	$	151.3

Our variable lease cost during 2022, 2021 and 2020 primarily related to operating expenses, taxes and insurance associated with our finance leases.

Our leases are included on our consolidated balance sheets as follows:


	As of December 31,
	2022		2021
	(in millions)
Finance leases
Property and equipment, net	$	315.5	$	400.1
Total finance lease assets	$	315.5	$	400.1

Other current liabilities	$	40.8	$	46.9
Long-term finance lease liabilities	430.8		509.8
Total finance lease liabilities	$	471.6	$	556.7

Operating leases
Operating lease assets	$	347.4	$	330.3
Total operating lease assets	$	347.4	$	330.3

Other current liabilities	$	48.6	$	33.3
Long-term operating lease liabilities	379.5		377.4
Total operating lease liabilities	$	428.1	$	410.7

Maturities of our finance and operating lease liabilities as of December 31, 2022 were as follows:


Year	Finance Leases		Operating Leases		Total
	(in millions)
2023	$	76.0	$	58.4	$	134.4
2024	88.7		44.3		133.0
2025	89.0		40.2		129.2
2026	89.3		39.4		128.7
2027	89.7		35.3		125.0
Thereafter	233.6		273.7		507.3
Total lease payments	666.3		491.3		1,157.6
Less: amount representing interest	(194.7)		(63.2)		(257.9)
Present value of lease liabilities	$	471.6	$	428.1	$	899.7

The weighted-average remaining lease terms and discount rates related to our leases were as follows:


	As of December 31,
	2022		2021
Weighted-average remaining lease term (in years)
Finance leases	10.60		10.73
Operating leases	11.57		12.81

Weighted-average discount rate
Finance leases	8.36	%	8.11	%
Operating leases	2.46	%	2.19	%

Supplemental cash flow information related to our leases was as follows:


	2022		2021		2020
	(in millions)
Cash paid for amounts included in the measurement of lease liabilities
Operating cash flows from operating leases	$	50.8	$	21.5	$	16.3
Operating cash flows from finance leases	$	42.5	$	46.2	$	48.9
Financing cash flows from finance leases	$	85.5	$	47.0	$	42.3

Right-of-use assets obtained in exchange for lease obligations
Operating leases	$	58.6	$	36.3	$	293.6
Finance leases	$	—	$	—	$	33.1

Leases - Supplemental Cash Flow Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Cash paid for amounts included in the measurement of lease liabilities
Operating cash flows from operating leases	$ 50.8	$ 21.5	$ 16.3
Operating cash flows from finance leases	42.5	46.2	48.9
Financing cash flows from finance leases	85.5	47.0	42.3
Right-of-use assets obtained in exchange for lease obligations
Operating leases	58.6	36.3	293.6
Finance leases	$ 0.0	$ 0.0	$ 33.1

Acquired In-Process Research and Development and Other Arrangements - Additional Information (Details)		3 Months Ended	12 Months Ended
	Feb. 10, 2023 USD ($)	Jun. 30, 2021 USD ($)	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)	Dec. 31, 2020 USD ($)	Dec. 31, 2019 USD ($) target	Jul. 01, 2021
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Acquired in-process research and development expenses			$ 115,500,000	$ 1,113,300,000	$ 184,600,000
Catalyst Biosciences
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Asset acquisition, consideration transferred			60,000,000
CRISPR Therapeutics
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Collaborative arrangement, right to exclusively license, number of targets \| target						3
Collaborative arrangement development and regulatory potential milestone payments maximum						$ 410,000,000
CRSIPR A&R JDCA
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Collaborative arrangement development and regulatory potential milestone payments maximum		$ 200,000,000
Up-front payment		$ 900,000,000
Allocation of net profits and net losses, percent							60.00%
CRSIPR A&R JDCA \| CRISPR
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Allocation of net profits and net losses, percent							40.00%
Entrada Therapeutics \| Subsequent Event
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Collaborative arrangement development and regulatory potential milestone payments maximum	$ 485,000,000
Up-front payment	224,000,000
Purchase of common stock	$ 26,000,000
Verve
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Collaborative arrangement development and regulatory potential milestone payments maximum			340,000,000
Up-front payment			25,000,000
Purchase of common stock			35,000,000
Collaborative arrangement development and regulatory potential milestone additional payments			66,000,000
ApolLo1 Bio, LLC
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Collaborative arrangement, milestone payment				15,000,000
Collaborative arrangement, option payment				60,000,000
Moderna Agreement
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Collaborative arrangement development and regulatory potential milestone payments maximum					380,000,000
Up-front payment					75,000,000
Mammoth Biosciences, Inc
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Up-front payment				31,000,000
Arbor Biotechnologies, Inc
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Up-front payment				25,000,000
Skyhawk Therapeutics Inc
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Up-front payment					40,000,000
Additional In-License Agreements and Other Arrangements [Member]
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Acquired in-process research and development expenses			$ 30,500,000	$ 138,300,000	$ 109,600,000

Hedging - Offsetting Derivatives (Details) - Cash Flow Hedging - Designated as hedging instruments - Foreign currency forward contracts - USD ($) $ in Millions	Dec. 31, 2022	Dec. 31, 2021
Total assets
Gross Amounts Recognized	$ 48.3	$ 46.5
Gross Amounts Offset	0.0	0.0
Gross Amounts Presented	48.3	46.5
Gross Amounts Not Offset	(15.2)	(8.3)
Legal Offset	33.1	38.2
Total liabilities
Total liabilities	(15.2)	(8.3)
Gross Amounts Offset	0.0	0.0
Gross Amounts Presented	(15.2)	(8.3)
Gross Amounts Not Offset	15.2	8.3
Legal Offset	$ 0.0	$ 0.0

Additional Balance Sheet Detail - Accrued Expenses and Other Current Liabilities (Details) - USD ($) $ in Millions	Dec. 31, 2022	Dec. 31, 2021
Accrued expenses
Product revenue accruals	$ 1,300.8	$ 847.4
Payroll and benefits	246.5	191.3
Research, development and commercial contract costs	198.7	171.6
Royalty payable	215.0	200.4
Tax related accruals	123.3	211.3
Other	42.4	56.6
Total	2,126.7	1,678.6
Other current liabilities
Contract liabilities	159.6	171.7
Finance lease liabilities	40.8	46.9
Operating lease liabilities	48.6	33.3
Other	62.5	16.5
Total	$ 311.5	$ 268.4

Cover - USD ($) $ in Billions	12 Months Ended
Cover - USD ($) $ in Billions	Dec. 31, 2022	Jan. 31, 2023	Jun. 30, 2022
Cover [Abstract]
Document Type	10-K
Document Annual Report	true
Document Period End Date	Dec. 31, 2022
Current Fiscal Year End Date	--12-31
Document Transition Report	false
Entity File Number	000-19319
Entity Registrant Name	VERTEX PHARMACEUTICALS INC / MA
Entity Incorporation, State or Country Code	MA
Entity Tax Identification Number	04-3039129
Entity Address, Address Line One	50 Northern Avenue
Entity Address, City or Town	Boston
Entity Address, State or Province	MA
Entity Address, Postal Zip Code	02210
City Area Code	617
Local Phone Number	341-6100
Title of 12(b) Security	Common Stock, $0.01 Par Value Per Share
Trading Symbol	VRTX
Security Exchange Name	NASDAQ
Entity Well-known Seasoned Issuer	Yes
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
ICFR Auditor Attestation Flag	true
Entity Shell Company	false
Entity Public Float			$ 71.8
Entity Common Stock, Shares Outstanding		257,091,441
Documents Incorporated by Reference	Portions of the definitive proxy statement for the 2023 Annual Meeting of Shareholders, which we expect to hold on May 17, 2023, are incorporated by reference into Part III of this Annual Report on Form 10-K.
Entity Central Index Key	0000875320
Document Fiscal Year Focus	2022
Document Fiscal Period Focus	FY
Amendment Flag	false

Accumulated Other Comprehensive Income (Loss)

12 Months Ended

Dec. 31, 2022

Equity [Abstract]

Accumulated Other Comprehensive Income (Loss)

The following table summarizes the changes in accumulated other comprehensive income (loss) by component:


			Unrealized Holding Gains (Losses), Net of Tax
	Foreign Currency Translation Adjustment		On Available-For-Sale Debt Securities		On Foreign Currency Forward Contracts		Total
	(in millions)
Balance as of December 31, 2019	$	(0.9)	$	0.5	$	(1.6)	$	(2.0)
Other comprehensive loss before reclassifications	(14.7)		(0.2)		(54.5)		(69.4)
Amounts reclassified from accumulated other comprehensive income (loss)	—		—		2.9		2.9
Net current period other comprehensive loss	(14.7)		(0.2)		(51.6)		(66.5)
Balance as of December 31, 2020	$	(15.6)	$	0.3	$	(53.2)	$	(68.5)
Other comprehensive income (loss) before reclassifications	2.0		(0.8)		59.7		60.9
Amounts reclassified from accumulated other comprehensive income (loss)	—		—		23.5		23.5
Net current period other comprehensive income (loss)	2.0		(0.8)		83.2		84.4
Balance as of December 31, 2021	$	(13.6)	$	(0.5)	$	30.0	$	15.9
Other comprehensive (loss) income before reclassifications	(11.4)		(3.3)		138.9		124.2
Amounts reclassified from accumulated other comprehensive income (loss)	—		3.7		(143.0)		(139.3)
Net current period other comprehensive (loss) income	(11.4)		0.4		(4.1)		(15.1)
Balance as of December 31, 2022	$	(25.0)	$	(0.1)	$	25.9	$	0.8

Common Stock, Preferred Stock and Equity Plans - Stock and Option Plans (Details)	12 Months Ended
	Dec. 31, 2022 shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Awards outstanding (in shares)	6,667,000
Additional awards authorized for grant (in shares)	19,695,000
2013 Stock and Option Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Awards outstanding (in shares)	6,553,000
Additional awards authorized for grant (in shares)	19,695,000
Additional shares authorized (in shares)	13,500,000
2006 Stock and Option Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Awards outstanding (in shares)	114,000
Additional awards authorized for grant (in shares)	0
Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expiration period	10 years

Income Taxes

12 Months Ended

Dec. 31, 2022

Income Tax Disclosure [Abstract]

Income Taxes

We are subject to U.S. federal, state, and foreign income taxes. The components of income before provision for income taxes during the three years ended December 31, 2022, consisted of the following:


	2022		2021		2020
	(in millions)
United States	$	3,257.0	$	2,030.7	$	2,885.4
Foreign	975.4		699.7		231.5
Income before provision for income taxes	$	4,232.4	$	2,730.4	$	3,116.9

The components of our provision for income taxes during the three years ended December 31, 2022, consisted of the following:


	2022		2021		2020
	(in millions)
Current taxes:
Federal	$	779.0	$	374.9	$	71.4
State	34.9		26.5		18.9
Foreign	372.4		141.5		37.6
Total current taxes	1,186.3		542.9		127.9
Deferred taxes:
Federal	(404.0)		(36.9)		510.2
State	(11.0)		(19.3)		6.7
Foreign	139.1		(98.4)		(239.6)
Total deferred taxes	(275.9)		(154.6)		277.3
Provision for income taxes	$	910.4	$	388.3	$	405.2

Unremitted Earnings

As of December 31, 2022, we are treating all our foreign subsidiaries earnings to be indefinitely reinvested. Upon repatriation of the indefinitely reinvested earnings, in the form of dividends or otherwise, we could be subject to U.S. federal withholding taxes payable to various foreign countries and income taxes in certain states. We do not provide for deferred taxes on the excess of financial statement reporting over the tax basis of our investments in our foreign subsidiaries as they are deemed to be essentially permanent in duration. These permanently reinvested basis differences could reverse if we sell our foreign subsidiaries or various other events occur, none of which were considered probable as of December 31, 2022. The tax liabilities described above would not be material to our consolidated financial statements.

Effective Tax Rate Reconciliation

A reconciliation between the U.S. federal statutory rate of 21% and our effective tax rate is as follows:


	2022		2021		2020
Federal statutory tax rate	21.0	%	21.0	%	21.0	%
State taxes, net of federal benefit	0.6	%	0.8	%	0.6	%
Foreign income tax rate differential	(0.3)	%	(0.3)	%	0.2	%
U.S. tax on foreign earnings, net of credits	1.9	%	0.7	%	2.7	%
Foreign derived intangible income deduction	(1.4)	%	(0.8)	%	(0.2)	%
Tax credits	(2.2)	%	(6.4)	%	(1.8)	%
Tax rate change	0.0	%	(3.5)	%	(1.2)	%
Stock compensation (benefit), shortfalls and cancellations	(0.8)	%	0.0	%	(2.3)	%
Long-term intercompany receivable write-off	—	%	—	%	(1.7)	%
Uncertain tax positions	2.7	%	2.0	%	1.3	%
Intra-entity transfer of intellectual property rights	—	%	—	%	(6.7)	%
Other	0.0	%	0.7	%	1.1	%
Effective tax rate	21.5	%	14.2	%	13.0	%

Our 21.5% effective tax rate for 2022 was higher than the U.S. statutory rate primarily due to an increase in our unrecognized tax benefit liabilities associated with intercompany transfer pricing matters offset by excess tax benefits related to stock-based compensation, tax credits and changes in our estimated to prior-year tax liabilities.

Our 14.2% effective tax rate for 2021 was lower than the U.S. statutory rate primarily due to discrete tax benefits of (i) $94.8 million associated with an increase in the United Kingdom’s (the “U.K.”) corporate tax rate from 19% to 25%, which was enacted in June 2021 and will become effective in April 2023, and (ii) $44.1 million resulting from an R&D tax credit study that we completed in 2021.

Our 13.0% effective tax rate for 2020 was lower than the U.S. statutory rate primarily due to (i) a discrete tax benefit of $209.0 million associated with an intra-entity transfer of intellectual property rights to our U.K. entity, (ii) a discrete tax benefit associated with the write-off of a long-term intercompany receivable, (iii) a discrete tax benefit associated with an increase in the U.K.’s corporate tax rate from 17% to 19%, which was enacted and became effective in July 2020, and (iv) excess tax benefits related to stock-based compensation. The impact of these items was partially offset by U.S. income tax on foreign earnings.

Deferred Tax Assets and Liabilities

Deferred tax assets and liabilities are determined based on the difference between financial statement and tax bases using enacted tax rates in effect for the year in which the differences are expected to reverse. The components of the deferred taxes were as follows:


	As of December 31,
	2022		2021
	(in millions)
Deferred tax assets:
Net operating loss	$	77.4	$	106.6
Tax credit carryforwards	223.0		202.4
Intangible assets	738.5		802.8
Stock-based compensation	124.4		94.6
Finance lease liabilities	94.9		103.4
Operating lease assets	79.6		81.1
R&D capitalization	438.3		—
Other	69.2		90.3
Gross deferred tax assets	1,845.3		1,481.2
Valuation allowance	(237.8)		(220.4)
Total deferred tax assets	1,607.5		1,260.8
Deferred tax liabilities:
Property and equipment	(139.8)		(118.2)
Acquired intangibles	(130.5)		(87.0)
Operating lease liabilities	(63.1)		(64.8)
Other	(27.2)		(56.3)
Total deferred tax liabilities	(360.6)		(326.3)
Net deferred tax assets	$	1,246.9	$	934.5

On a periodic basis, we reassess the valuation allowance on our deferred income tax assets, weighing positive and negative evidence to assess the recoverability of our deferred tax assets. As of December 31, 2022, we maintained a valuation allowance of $237.8 million related primarily to U.S. state tax attributes.

In addition to deferred tax assets and liabilities, we have recorded deferred charges related to intra-entity sales of inventory. As of December 31, 2022 and 2021, the total deferred charges were $195.1 million and $225.4 million, respectively.

As of December 31, 2022, we had net operating loss (“NOL”) carryforwards of $65.3 million, which are subject to annual utilization limitations for U.S. federal income tax purposes. In 2027, our definite lived U.S. federal NOLs of $19.8 million will begin to expire, while the remaining portion may be carried forward indefinitely. For U.S. state income tax purposes, we had NOL carryforwards of $553.8 million and tax credit carryforwards of $273.5 million. The state NOL and tax credit carryforwards begin to expire in 2023. For foreign income tax purposes, we had NOL carryforwards of $151.4 million and tax credit carryforwards of $21.5 million. The foreign NOL carryforwards may be carried forward indefinitely, with the exception of $70.0 million that will expire in 2041. The foreign tax credit carryforwards will begin to expire in 2026.

Unrecognized Tax Benefits

Unrecognized tax benefits during the three years ended December 31, 2022 were as follows:


	2022		2021		2020
	(in millions)
Balance at beginning of the period	$	147.2	$	86.6	$	33.9
Increases related to current period tax positions	128.3		42.0		26.7
Increases related to prior period tax positions	205.3		19.9		26.7
Decreases related to prior period tax positions	(14.4)		—		—
Statute of limitations expiration	(4.5)		(1.3)		(0.7)
Foreign currency translation adjustment	(2.3)		—		—
Balance at end of period	$	459.6	$	147.2	$	86.6

During 2022, we increased our gross unrecognized tax benefits by $312.4 million, primarily associated with intercompany transfer pricing matters. This unrecognized tax benefit was recorded as a $29.7 million reduction to our gross deferred tax assets and a $282.7 million gross tax liability.

As of December 31, 2022, we have classified $44.1 million and $415.5 million of our unrecognized tax benefits as credits to “Deferred tax assets” and “Other long-term liabilities,” respectively, on our consolidated balance sheet.

Included in our unrecognized tax benefits as of December 31, 2022, 2021 and 2020, we had $208.5 million, $129.5 million and $75.8 million (net of the federal benefit on state issues), respectively, of unrecognized tax benefits, which would affect our effective income tax rate if recognized.

We recognize potential interest and penalties related to unrecognized tax benefits in our provision for income taxes. In 2022, we recognized total interest and penalty expenses of $36.6 million. As of December 31, 2022, our accrual for interest and penalties was $39.2 million. Our total interest and penalty expenses in 2021 and 2020 and our accrual for interest and penalties as of December 31, 2021 were not material to our consolidated financial statements.

The U.S. Internal Revenue Service and other local and foreign tax authorities routinely examine our tax returns, including intercompany transfer pricing, and it is reasonably possible that we will adjust the value of our uncertain tax positions related these matters and other issues as we receive additional information from various taxing authorities, including reaching settlements with such authorities.

As a result of various audit closures, settlements and statutes of limitations, we estimate that it is reasonably possible that our gross unrecognized tax benefits could decrease by up to $9.1 million in the next 12 months due to statute of limitations expirations.

We file U.S. federal income tax returns and income tax returns in various state, local and foreign jurisdictions. We have various income tax audits ongoing at any time throughout the world. Except for jurisdictions where we have NOLs or tax credit carryforwards, we are no longer subject to any tax assessment from tax authorities for years prior to 2014 in jurisdictions that have a material impact on our consolidated financial statements.

- Definition

The entire disclosure for income taxes. Disclosures may include net deferred tax liability or asset recognized in an enterprise's statement of financial position, net change during the year in the total valuation allowance, approximate tax effect of each type of temporary difference and carryforward that gives rise to a significant portion of deferred tax liabilities and deferred tax assets, utilization of a tax carryback, and tax uncertainties information.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section 50
-Paragraph 21
-URI https://asc.fasb.org/extlink&oid=121826272&loc=d3e32857-109319

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section S99
-Paragraph 2
-Subparagraph (SAB Topic 11.C)
-URI https://asc.fasb.org/extlink&oid=122134291&loc=d3e330215-122817

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section 50
-Paragraph 17
-Subparagraph (b)
-URI https://asc.fasb.org/extlink&oid=121826272&loc=d3e32809-109319

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SAB TOPIC 6.I.5.Q1)
-URI https://asc.fasb.org/extlink&oid=122134291&loc=d3e330036-122817

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 10
-Section 50
-Paragraph 14
-URI https://asc.fasb.org/extlink&oid=121826272&loc=d3e32705-109319

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 270
-Section 50
-Paragraph 1
-URI https://asc.fasb.org/extlink&oid=6424409&loc=d3e44925-109338

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-URI https://asc.fasb.org/topic&trid=2144680

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 740
-SubTopic 30
-Section 50
-Paragraph 2
-Subparagraph (a)
-URI https://asc.fasb.org/extlink&oid=6424122&loc=d3e41874-109331

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 235
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(h)(2))
-URI https://asc.fasb.org/extlink&oid=120395691&loc=d3e23780-122690

+ Details

Fair Value Measurements - Additional Information (Details) $ in Millions	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Cash	$ 3,100.0	$ 3,300.0
Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Remaining milestone payment	$ 678.3
Level 3 \| Minimum \| Discount Rate
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration, measurement input (percent)	0.051
Level 3 \| Maximum \| Discount Rate
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration, measurement input (percent)	0.060

Leases - Weighted-Average Remaining Lease Terms and Discount Rates (Details)	Dec. 31, 2022	Dec. 31, 2021
Weighted-average remaining lease term (in years)
Finance leases	10 years 7 months 6 days	10 years 8 months 23 days
Operating leases	11 years 6 months 25 days	12 years 9 months 21 days
Weighted-average discount rate
Finance leases	8.36%	8.11%
Operating leases	2.46%	2.19%

Earnings Per Share (Tables)

12 Months Ended

Dec. 31, 2022

Earnings Per Share [Abstract]

Schedule of Earnings Per Share, Basic and Diluted

The following table sets forth the computation of basic and diluted net income per common share for the periods ended:


	2022		2021		2020
	(in millions, except per share amounts)
Net income	$	3,322.0	$	2,342.1	$	2,711.7

Basic weighted-average common shares outstanding	256.1		257.7		259.8
Effect of potentially dilutive securities:
Stock options	1.4		1.1		1.8
Restricted stock units (including PSUs)	1.6		1.1		1.7
Employee stock purchase program	0.0		0.0		0.1
Diluted weighted-average common shares outstanding	259.1		259.9		263.4

Basic net income per common share	$	12.97	$	9.09	$	10.44
Diluted net income per common share	$	12.82	$	9.01	$	10.29

Schedule of Potential Gross Common Equivalent Shares

We did not include the securities in the following table in the computation of the diluted net income per common share because the effect would have been anti-dilutive during each period:


	2022	2021	2020
	(in millions)
Stock options	0.0	0.7	0.3
Unvested restricted stock units (including PSUs)	0.2	0.4	0.3

Consolidated Balance Sheets (Parenthetical) - $ / shares	Dec. 31, 2022	Dec. 31, 2021
Statement of Financial Position [Abstract]
Preferred stock, par value (in dollars per share)	$ 0.01	$ 0.01
Preferred stock, shares authorized (in shares)	1,000,000	1,000,000
Preferred stock, shares issued (in shares)	0	0
Preferred stock, shares outstanding (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock, shares authorized (in shares)	500,000,000	500,000,000
Common stock, shares issued (in shares)	257,011,628	254,479,046
Common stock, shares outstanding (in shares)	257,011,628	254,479,046

Property and Equipment

12 Months Ended

Dec. 31, 2022

Property, Plant and Equipment [Abstract]

Property and Equipment

“Property and equipment, net” consisted of the following:


	As of December 31,
	2022		2021
	(in millions)
Buildings and improvements	$	903.1	$	892.5
Laboratory equipment, other equipment and furniture	476.5		407.3
Leasehold improvements	410.9		363.5
Computers and software	312.1		293.7
Land	33.1		33.1
Total property and equipment, gross	2,135.7		1,990.1
Less: accumulated depreciation	(1,027.3)		(896.0)
Total property and equipment, net	$	1,108.4	$	1,094.1

We recorded depreciation expense of $148.3 million, $125.6 million and $109.5 million in 2022, 2021 and 2020, respectively, which includes our finance lease amortization.

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2022

Income Tax Disclosure [Abstract]

Schedule of Components of Income Before Provision for (Benefit From) Income Taxes

The components of income before provision for income taxes during the three years ended December 31, 2022, consisted of the following:


	2022		2021		2020
	(in millions)
United States	$	3,257.0	$	2,030.7	$	2,885.4
Foreign	975.4		699.7		231.5
Income before provision for income taxes	$	4,232.4	$	2,730.4	$	3,116.9

Schedule of Components of Provision for (Benefit From) Income Taxes

The components of our provision for income taxes during the three years ended December 31, 2022, consisted of the following:


	2022		2021		2020
	(in millions)
Current taxes:
Federal	$	779.0	$	374.9	$	71.4
State	34.9		26.5		18.9
Foreign	372.4		141.5		37.6
Total current taxes	1,186.3		542.9		127.9
Deferred taxes:
Federal	(404.0)		(36.9)		510.2
State	(11.0)		(19.3)		6.7
Foreign	139.1		(98.4)		(239.6)
Total deferred taxes	(275.9)		(154.6)		277.3
Provision for income taxes	$	910.4	$	388.3	$	405.2

Schedule of Reconciliation of the Provision for (Benefit From) Income Taxes

A reconciliation between the U.S. federal statutory rate of 21% and our effective tax rate is as follows:


	2022		2021		2020
Federal statutory tax rate	21.0	%	21.0	%	21.0	%
State taxes, net of federal benefit	0.6	%	0.8	%	0.6	%
Foreign income tax rate differential	(0.3)	%	(0.3)	%	0.2	%
U.S. tax on foreign earnings, net of credits	1.9	%	0.7	%	2.7	%
Foreign derived intangible income deduction	(1.4)	%	(0.8)	%	(0.2)	%
Tax credits	(2.2)	%	(6.4)	%	(1.8)	%
Tax rate change	0.0	%	(3.5)	%	(1.2)	%
Stock compensation (benefit), shortfalls and cancellations	(0.8)	%	0.0	%	(2.3)	%
Long-term intercompany receivable write-off	—	%	—	%	(1.7)	%
Uncertain tax positions	2.7	%	2.0	%	1.3	%
Intra-entity transfer of intellectual property rights	—	%	—	%	(6.7)	%
Other	0.0	%	0.7	%	1.1	%
Effective tax rate	21.5	%	14.2	%	13.0	%

Schedule of Deferred Tax Assets and Liabilities

The components of the deferred taxes were as follows:


	As of December 31,
	2022		2021
	(in millions)
Deferred tax assets:
Net operating loss	$	77.4	$	106.6
Tax credit carryforwards	223.0		202.4
Intangible assets	738.5		802.8
Stock-based compensation	124.4		94.6
Finance lease liabilities	94.9		103.4
Operating lease assets	79.6		81.1
R&D capitalization	438.3		—
Other	69.2		90.3
Gross deferred tax assets	1,845.3		1,481.2
Valuation allowance	(237.8)		(220.4)
Total deferred tax assets	1,607.5		1,260.8
Deferred tax liabilities:
Property and equipment	(139.8)		(118.2)
Acquired intangibles	(130.5)		(87.0)
Operating lease liabilities	(63.1)		(64.8)
Other	(27.2)		(56.3)
Total deferred tax liabilities	(360.6)		(326.3)
Net deferred tax assets	$	1,246.9	$	934.5

Summary of Unrecognized Tax Benefits

Unrecognized tax benefits during the three years ended December 31, 2022 were as follows:


	2022		2021		2020
	(in millions)
Balance at beginning of the period	$	147.2	$	86.6	$	33.9
Increases related to current period tax positions	128.3		42.0		26.7
Increases related to prior period tax positions	205.3		19.9		26.7
Decreases related to prior period tax positions	(14.4)		—		—
Statute of limitations expiration	(4.5)		(1.3)		(0.7)
Foreign currency translation adjustment	(2.3)		—		—
Balance at end of period	$	459.6	$	147.2	$	86.6

Hedging

12 Months Ended

Dec. 31, 2022

Derivative Instruments and Hedging Activities Disclosure [Abstract]

Hedging

Foreign currency forward contracts - Designated as hedging instruments

We maintain a hedging program intended to mitigate the effect of changes in foreign exchange rates for a portion of our forecasted product revenues denominated in certain foreign currencies. The program includes foreign currency forward contracts that are designated as cash flow hedges under U.S. GAAP having contractual durations from one to eighteen months. We recognize realized gains and losses for the effective portion of such contracts in “Product revenues, net” in our consolidated statements of operations in the same period that we recognize the product revenues that were impacted by the hedged foreign exchange rate changes.

We formally document the relationship between foreign currency forward contracts (hedging instruments) and forecasted product revenues (hedged items), as well as our risk management objective and strategy for undertaking various hedging activities, which includes matching all foreign currency forward contracts that are designated as cash flow hedges to forecasted transactions. We also formally assess, both at the hedge’s inception and on an ongoing basis, whether the foreign currency forward contracts are highly effective in offsetting changes in cash flows of hedged items on a prospective and retrospective basis. If we were to determine that a (i) foreign currency forward contract is not highly effective as a cash flow hedge, (ii) foreign currency forward contract has ceased to be a highly effective hedge or (iii) forecasted transaction is no longer probable of occurring, we would discontinue hedge accounting treatment prospectively. We measure effectiveness based on the change in fair value of the forward contracts and the fair value of the hypothetical foreign currency forward contracts with terms that match the critical terms of the risk being hedged. As of December 31, 2022, all hedges were

determined to be highly effective.

We consider the impact of our counterparties’ credit risk on the fair value of the foreign currency forward contracts. As of December 31, 2022 and December 31, 2021, credit risk did not change the fair value of our foreign currency forward contracts.

The following table summarizes the notional amount in U.S. dollars of our outstanding foreign currency forward contracts designated as cash flow hedges under U.S. GAAP:


	As of December 31,
	2022		2021
Foreign Currency	(in millions)
Euro	$	1,497.7	$	1,364.5
British pound sterling	247.4		287.7
Canadian dollar	216.3		89.9
Australian dollar	174.9		96.3
Swiss Franc	65.2		54.1
Total foreign currency forward contracts	$	2,201.5	$	1,892.5

Foreign currency forward contracts - Not designated as hedging instruments

We also enter into foreign currency forward contracts with contractual maturities of less than one month, which are designed to mitigate the effect of changes in foreign exchange rates on monetary assets and liabilities, including intercompany balances. These contracts are not designated as hedging instruments under U.S. GAAP. We recognize realized gains and losses for such contracts in “Other (expense) income, net” in our consolidated statements of operations each period. As of December 31, 2022, the notional amount of our outstanding foreign currency forward contracts where hedge accounting under U.S. GAAP is not applied was $1.0 billion.

During the three years ended December 31, 2022, we recognized the following related to foreign currency forward contracts in our consolidated statements of operations:


	December 31,
	2022		2021		2020
	(in millions)
Designated as hedging instruments - Reclassified from AOCI
Product revenues, net	$	182.5	$	(30.0)	$	(3.7)
Not designated as hedging instruments
Other (expense) income, net	$	(9.9)	$	(18.6)	$	22.1

Total reported in the Consolidated Statements of Operations
Product revenues, net	$	8,930.7	$	7,573.4	$	6,202.8
Other (expense) income, net	$	(164.8)	$	4.9	$	296.6

The following table summarizes the fair value of our outstanding foreign currency forward contracts designated as cash flow hedges under U.S. GAAP included on our consolidated balance sheets:


As of December 31, 2022
Assets			Liabilities
Classification	Fair Value		Classification	Fair Value
(in millions)
Prepaid expenses and other current assets	$	47.5	Other current liabilities	$	(14.3)
Other assets	0.8		Other long-term liabilities	(0.9)
Total assets	$	48.3	Total liabilities	$	(15.2)


As of December 31, 2021
Assets			Liabilities
Classification	Fair Value		Classification	Fair Value
(in millions)
Prepaid expenses and other current assets	$	44.5	Other current liabilities	$	(5.6)
Other assets	2.0		Other long-term liabilities	(2.7)
Total assets	$	46.5	Total liabilities	$	(8.3)

As of December 31, 2022, we expect the amounts that are related to foreign exchange forward contracts designated as cash flow hedges under U.S. GAAP recorded in “Prepaid expenses and other current assets” and “Other current liabilities” to be reclassified to earnings within twelve months.

As discussed in “Note A, “Nature of Business and Accounting Policies,” we present the fair value of our foreign currency forward contracts on a gross basis within our consolidated balance sheets. The following table summarizes the potential effect of offsetting derivatives by type of financial instrument designated as cash flow hedges under U.S. GAAP on our consolidated balance sheets:


	As of December 31, 2022
	Gross Amounts Recognized		Gross Amounts Offset		Gross Amounts Presented		Gross Amounts Not Offset		Legal Offset
Foreign currency forward contracts	(in millions)
Total assets	$	48.3	$	—	$	48.3	$	(15.2)	$	33.1
Total liabilities	(15.2)		—		(15.2)		15.2		—


	As of December 31, 2021
	Gross Amounts Recognized		Gross Amounts Offset		Gross Amounts Presented		Gross Amounts Not Offset		Legal Offset
Foreign currency forward contracts	(in millions)
Total assets	$	46.5	$	—	$	46.5	$	(8.3)	$	38.2
Total liabilities	(8.3)		—		(8.3)		8.3		—

Stock-based Compensation Expense (Tables)

12 Months Ended

Dec. 31, 2022

Share-Based Payment Arrangement [Abstract]

Schedule of Stock-based Compensation Expense by Line Item

The effect of stock-based compensation expense during the three years ended December 31, 2022 was as follows:


	2022		2021		2020
	(in millions)
Stock-based compensation expense by line item:
Cost of sales	$	9.4	$	6.3	$	5.6
Research and development expenses	297.9		268.3		262.7
Selling, general and administrative expenses	184.0		166.8		161.2
Total stock-based compensation expense included in costs and expenses	491.3		441.4		429.5
Income tax effect	(144.1)		(82.9)		(147.0)
Total stock-based compensation included in costs and expenses, net of tax	$	347.2	$	358.5	$	282.5

The stock-based compensation expense by type of award during the three years ended December 31, 2022 was as follows:


	2022		2021		2020
	(in millions)
Stock-based compensation expense by type of award:
Restricted stock units (including PSUs)	$	456.1	$	384.3	$	360.4
Stock options	17.6		36.8		59.7
ESPP share issuances	16.7		24.4		13.0
Stock-based compensation expense related to inventories	0.9		(4.1)		(3.6)
Total stock-based compensation expense included in costs and expenses	$	491.3	$	441.4	$	429.5

Schedule of Unrecognized Stock-Based Compensation Expense


	As of December 31, 2022
	Unrecognized Expense		Weighted-average Recognition Period
	(in millions)		(in years)
Type of award:
Restricted stock units (including PSUs)	$	477.9	1.93
Stock options	2.2		0.42
ESPP share issuances	11.3		0.61
Total unrecognized stock-based compensation expense	$	491.4

Schedule of Assumptions Used to Estimate the Grant Date Fair Value of Options

The fair value of each option granted during 2022, 2021 and 2020 was estimated on the date of grant using the Black-Scholes option pricing model with the following weighted-average assumptions:


	2022	2021	2020
Stock options granted	20,079	27,302	22,636

Expected stock price volatility	34.03%	35.03%	35.87%
Risk-free interest rate	2.93%	0.86%	0.43%
Expected term of options (in years)	4.36	4.50	4.67
Expected annual dividends	—	—	—

Schedule of Assumptions Used to Estimate the Grant Date Fair Value Employee Stock Purchase Plan

The following table reflects the weighted-average assumptions used in the Black-Scholes option pricing model for 2022, 2021 and 2020:


	2022	2021	2020
Expected stock price volatility	33.55%	34.06%	37.70%
Risk-free interest rate	4.05%	0.05%	0.11%
Expected term (in years)	0.71	0.69	0.71
Expected annual dividends	—	—	—

Acquired In-Process Research and Development and Other Arrangements (Tables)

12 Months Ended

Dec. 31, 2022

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Schedule of Collaborative Arrangement Costs

During the three years ended December 31, 2022, we recognized the following amounts in total, not including amounts recorded to “Acquired in-process research and development expenses,” related to these agreements:


	2022		2021		2020
	(in millions)
Total expenses incurred under the Original CTX001 JDCA and A&R JDCA	$	365.8	$	230.4	$	101.2
Vertex’s share recognized in “Total costs and expenses” in our consolidated statements of operations	251.1		129.0		50.6

Segment Information - Revenues by Product (Details) $ in Millions	12 Months Ended
	Dec. 31, 2022 USD ($) segment	Dec. 31, 2021 USD ($)	Dec. 31, 2020 USD ($)
Revenue from External Customer [Line Items]
Number of operating segments \| segment	1
Total product revenues, net	$ 8,930.7	$ 7,574.4	$ 6,205.7
TRIKAFTA/KAFTRIO
Revenue from External Customer [Line Items]
Total product revenues, net	7,686.8	5,697.2	3,863.8
SYMDEKO/SYMKEVI
Revenue from External Customer [Line Items]
Total product revenues, net	180.0	420.4	628.6
ORKAMBI
Revenue from External Customer [Line Items]
Total product revenues, net	510.7	771.6	907.5
KALYDECO
Revenue from External Customer [Line Items]
Total product revenues, net	553.2	684.2	802.9
Product revenues, net
Revenue from External Customer [Line Items]
Total product revenues, net	$ 8,930.7	$ 7,573.4	$ 6,202.8

- Definition

+ References

+ Details

Consolidated Balance Sheets - USD ($) $ in Millions	Dec. 31, 2022	Dec. 31, 2021
Current assets:
Cash and cash equivalents	$ 10,504.0	$ 6,795.0
Marketable securities	274.5	729.9
Accounts receivable, net	1,442.2	1,136.8
Inventories	460.6	353.1
Prepaid expenses and other current assets	553.5	545.8
Total current assets	13,234.8	9,560.6
Property and equipment, net	1,108.4	1,094.1
Goodwill	1,088.0	1,002.2
Intangible assets	603.6	400.0
Deferred tax assets	1,246.9	934.5
Operating lease assets	347.4	330.3
Other assets	521.8	110.8
Total assets	18,150.9	13,432.5
Current liabilities:
Accounts payable	303.9	195.0
Accrued expenses	2,126.7	1,678.6
Other current liabilities	311.5	268.4
Total current liabilities	2,742.1	2,142.0
Long-term finance lease liabilities	430.8	509.8
Long-term operating lease liabilities	379.5	377.4
Other long-term liabilities	685.8	303.3
Total liabilities	4,238.2	3,332.5
Commitments and contingencies	0.0	0.0
Shareholders’ equity:
Preferred stock, $0.01 par value; 1,000,000 shares authorized; none issued and outstanding	0.0	0.0
Common stock, $0.01 par value; 500,000,000 shares authorized, 257,011,628 and 254,479,046 shares issued and outstanding, respectively	2.6	2.5
Additional paid-in capital	7,386.5	6,880.8
Accumulated other comprehensive income	0.8	15.9
Retained earnings	6,522.8	3,200.8
Total shareholders’ equity	13,912.7	10,100.0
Total liabilities and shareholders’ equity	$ 18,150.9	$ 13,432.5

Fair Value Measurements - Fair Value of Contingent Consideration Liabilities (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance at December 31, 2021	$ 186.5
Decrease in fair value of contingent payments	(57.5)	$ (3.1)	$ 13.1
Balance at December 31, 2022	$ 129.0	$ 186.5

Income Taxes - Unrecognized Tax Benefits (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Reconciliation of Unrecognized Tax Benefits, Excluding Amounts Pertaining to Examined Tax Returns [Roll Forward]
Balance at beginning of the period	$ 147.2	$ 86.6	$ 33.9
Increases related to current period tax positions	128.3	42.0	26.7
Increases related to prior period tax positions	205.3	19.9	26.7
Decreases related to prior period tax positions	(14.4)	0.0	0.0
Statute of limitations expiration	(4.5)	(1.3)	(0.7)
Foreign currency translation adjustment	(2.3)	0.0	0.0
Balance at end of period	$ 459.6	$ 147.2	$ 86.6

Segment Information (Tables)

12 Months Ended

Dec. 31, 2022

Segment Reporting [Abstract]

Revenues by Product

Product revenues, net consisted of the following:


	2022		2021		2020
	(in millions)
TRIKAFTA/KAFTRIO	$	7,686.8	$	5,697.2	$	3,863.8
SYMDEKO/SYMKEVI	180.0		420.4		628.6
ORKAMBI	510.7		771.6		907.5
KALYDECO	553.2		684.2		802.9
Total product revenues, net	$	8,930.7	$	7,573.4	$	6,202.8

Revenues and Property and Equipment by Location

Net product revenues are attributed to countries based on the location of the customer and consisted of the following:


	2022		2021		2020
	(in millions)
United States	$	5,699.3	$	5,287.3	$	4,826.4
Outside of the United States
Europe	2,705.5		1,972.9		1,126.5
Other	525.9		313.2		249.9
Total product revenues outside of the United States	3,231.4		2,286.1		1,376.4
Total product revenues, net	$	8,930.7	$	7,573.4	$	6,202.8

Long-lived assets by location consisted of the following:


	As of December 31,
	2022		2021
	(in millions)
United States	$	1,365.5	$	1,348.1
Outside of the United States
United Kingdom	75.7		60.9
Other	14.6		15.4
Total long-lived assets outside of the United States	90.3		76.3
Total long-lived assets	$	1,455.8	$	1,424.4

Significant Customers


	Percent of Total Gross Product Revenues						Percent of Accounts Receivable
	Year Ended December 31,						As of December 31,
	2022		2021		2020		2022		2021
McKesson Corporation	25	%	22	%	20	%	22	%	21	%
Accredo Health Group, Inc.	12	%	12	%	15	%	<10%		10	%
Walgreen Co.	10	%	10	%	14	%	<10%		<10 %
Lloyds Pharmacy*	<10%		<10%		<10%		12	%	15	%
*A wholly-owned subsidiary of McKesson Corporation in the U.K. until 2022.

Common Stock, Preferred Stock and Equity Plans - Common Stock and Preferred Stock (Details)	12 Months Ended
	Dec. 31, 2022 vote shares	Dec. 31, 2021 shares
Equity [Abstract]
Common stock, shares authorized (in shares)	500,000,000	500,000,000
Common stock, number of votes per share \| vote	1
Preferred stock, shares authorized (in shares)	1,000,000	1,000,000
Preferred stock, shares issued (in shares)	0	0
Preferred stock, shares outstanding (in shares)	0	0

Hedging - Derivative Fair Value (Details) - Designated as hedging instruments - Foreign currency forward contracts - Cash Flow Hedging - USD ($) $ in Millions	Dec. 31, 2022	Dec. 31, 2021
Derivative [Line Items]
Total assets	$ 48.3	$ 46.5
Total liabilities	(15.2)	(8.3)
Prepaid expenses and other current assets
Derivative [Line Items]
Total assets	47.5	44.5
Other assets
Derivative [Line Items]
Total assets	0.8	2.0
Other current liabilities
Derivative [Line Items]
Total liabilities	(14.3)	(5.6)
Other long-term liabilities
Derivative [Line Items]
Total liabilities	$ (0.9)	$ (2.7)