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Consolidated Statement of Cash Flows - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2017
Dec. 31, 2016
Dec. 31, 2015
Cash Flows from Operating Activities      
Net income $ 2,418 $ 3,941 $ 4,459
Adjustments to reconcile net income to net cash provided by operating activities:      
Depreciation and amortization 4,637 5,441 6,375
Intangible asset impairment charges 646 3,948 162
Provisional charge for one-time transition tax related to the enactment of U.S. tax legislation 5,347 0 0
Charge for future payments related to AstraZeneca collaboration license options 500 0 0
Charge related to the settlement of worldwide Keytruda patent litigation 0 625 0
Foreign currency devaluation related to Venezuela 0 0 876
Net charge related to the settlement of Vioxx shareholder class action litigation 0 0 680
Equity income from affiliates (42) (86) (205)
Dividends and distributions from equity method affiliates 2 16 50
Deferred income taxes (2,621) (1,521) (764)
Share-based compensation 312 300 299
Other 269 313 874
Net changes in assets and liabilities:      
Accounts receivable 297 (619) (480)
Inventories (145) 206 805
Trade accounts payable 254 278 (37)
Accrued and other current liabilities (922) (2,018) (8)
Income taxes payable (3,291) 124 (266)
Noncurrent liabilities (123) (809) (277)
Other (1,091) 237 (5)
Net Cash Provided by Operating Activities 6,447 10,376 12,538
Cash Flows from Investing Activities      
Capital expenditures (1,888) (1,614) (1,283)
Purchases of securities and other investments (10,739) (15,651) (16,681)
Proceeds from sales of securities and other investments 15,664 14,353 20,413
Acquisition of Cubist Pharmaceuticals, Inc., net of cash acquired 0 0 (7,598)
Acquisitions of other businesses, net of cash acquired (396) (780) (146)
Dispositions of businesses, net of cash divested 0 0 316
Other 38 482 221
Net Cash Provided by (Used in) Investing Activities 2,679 (3,210) (4,758)
Cash Flows from Financing Activities      
Net change in short-term borrowings (26) 0 (1,540)
Payments on debt (1,103) (2,386) (2,906)
Proceeds from issuance of debt 0 1,079 7,938
Purchases of treasury stock (4,014) (3,434) (4,186)
Dividends paid to stockholders (5,167) (5,124) (5,117)
Proceeds from exercise of stock options 499 939 485
Other (195) (118) (61)
Net Cash Used in Financing Activities (10,006) (9,044) (5,387)
Effect of Exchange Rate Changes on Cash and Cash Equivalents 457 (131) (1,310)
Net (Decrease) Increase in Cash and Cash Equivalents (423) (2,009) 1,083
Cash and Cash Equivalents at Beginning of Year 6,515 8,524 7,441
Cash and Cash Equivalents at End of Year $ 6,092 $ 6,515 $ 8,524