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CONDENSED CONSOLIDATED STATEMENT OF CASH FLOWS - USD ($)
$ in Millions
 9 Months Ended
Sep. 30, 2017
Sep. 30, 2016
Cash Flows from Operating Activities    
Net income $ 3,456 $ 4,528
Adjustments to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization 3,509 4,286
Intangible asset impairment charges 376 572
Charge for future payments related to AstraZeneca collaboration license options 750 0
Deferred income taxes (601) (65)
Share-based compensation 232 225
Other (31) 200
Net changes in assets and liabilities (5,259) (3,002)
Net Cash Provided by Operating Activities 2,432 6,744
Cash Flows from Investing Activities    
Capital expenditures (1,173) (1,063)
Purchases of securities and other investments (8,397) (10,084)
Proceeds from sales of securities and other investments 12,533 11,300
Acquisitions of businesses, net of cash acquired (347) (778)
Other 121 (22)
Net Cash Provided by (Used in) Investing Activities 2,737 (647)
Cash Flows from Financing Activities    
Net change in short-term borrowings 1,962 909
Payments on debt (301) (2,386)
Purchases of treasury stock (2,312) (2,418)
Dividends paid to stockholders (3,884) (3,853)
Proceeds from exercise of stock options 481 790
Other (167) (109)
Net Cash Used in Financing Activities (4,221) (7,067)
Effect of Exchange Rate Changes on Cash and Cash Equivalents 438 353
Net Increase (Decrease) in Cash and Cash Equivalents 1,386 (617)
Cash and Cash Equivalents at Beginning of Year 6,515 8,524
Cash and Cash Equivalents at End of Period $ 7,901 $ 7,907