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Consolidated Statement of Cash Flows - USD ($) $ in Millions | 12 Months Ended
--- | ---
Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016
Cash Flows from Operating Activities |  |  |
Net income | $ 6,193 | $ 2,418 | $ 3,941
Adjustments to reconcile net income to net cash provided by operating activities: |  |  |
Depreciation and amortization | 4,519 | 4,676 | 5,471
Intangible asset impairment charges | 296 | 646 | 3,948
Charge for future payments related to collaboration license options | 650 | 500 | 0
Provisional charge for one-time transition tax related to the enactment of U.S. tax legislation | 0 | 5,347 | 0
Charge related to the settlement of worldwide Keytruda patent litigation | 0 | 0 | 625
Deferred income taxes | (509) | (2,621) | (1,521)
Share-based compensation | 348 | 312 | 300
Other | 978 | 190 | 213
Net changes in assets and liabilities: |  |  |
Accounts receivable | (418) | 297 | (619)
Inventories | (911) | (145) | 206
Trade accounts payable | 230 | 254 | 278
Accrued and other current liabilities | (341) | (922) | (2,018)
Income taxes payable | 827 | (3,291) | 124
Noncurrent liabilities | (266) | (123) | (809)
Other | (674) | (1,087) | 237
Net Cash Provided by Operating Activities | 10,922 | 6,451 | 10,376
Cash Flows from Investing Activities |  |  |
Capital expenditures | (2,615) | (1,888) | (1,614)
Purchases of securities and other investments | (7,994) | (10,739) | (15,651)
Proceeds from sales of securities and other investments | 15,252 | 15,664 | 14,353
Acquisitions, net of cash acquired | (431) | (396) | (780)
Other | 102 | 38 | 482
Net Cash Provided by (Used in) Investing Activities | 4,314 | 2,679 | (3,210)
Cash Flows from Financing Activities |  |  |
Net change in short-term borrowings | 5,124 | (26) | 0
Payments on debt | (4,287) | (1,103) | (2,386)
Proceeds from issuance of debt | 0 | 0 | 1,079
Purchases of treasury stock | (9,091) | (4,014) | (3,434)
Dividends paid to stockholders | (5,172) | (5,167) | (5,124)
Proceeds from exercise of stock options | 591 | 499 | 939
Other | (325) | (195) | (118)
Net Cash Used in Financing Activities | (13,160) | (10,006) | (9,044)
Effect of Exchange Rate Changes on Cash, Cash Equivalents and Restricted Cash | (205) | 457 | (131)
Net Increase (Decrease) in Cash, Cash Equivalents and Restricted Cash | 1,871 | (419) | (2,009)
Cash, Cash Equivalents and Restricted Cash at Beginning of Year (includes $4 million of restricted cash at January 1, 2018 included in Other Assets) | 6,096 | 6,515 | 8,524
Cash, Cash Equivalents and Restricted Cash at End of Year (includes $2 million of restricted cash at December 31, 2018 included in Other Assets) | $ 7,967 | $ 6,096 | $ 6,515

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- Definition Amount of cash inflow from exercise of stock options granted under share-based compensation arrangement. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 718 -SubTopic 10 -Section 50 -Paragraph 2A -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=109197908&loc=SL79508275-113901 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 14 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3255-108585 + Details
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- Definition The consolidated profit or loss for the period, net of income taxes, including the portion attributable to the noncontrolling interest. + References Reference 1: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 220 -SubTopic 10 -Section 45 -Paragraph 1A -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=114867106&loc=SL7669619-108580 Reference 2: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 810 -SubTopic 10 -Section 50 -Paragraph 1A -Subparagraph (a)(1) -URI http://asc.fasb.org/extlink&oid=109239629&loc=SL4573702-111684 Reference 3: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 220 -SubTopic 10 -Section 45 -Paragraph 1B -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=114867106&loc=SL7669625-108580 Reference 4: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 810 -SubTopic 10 -Section 50 -Paragraph 1A -Subparagraph (c)(1) -URI http://asc.fasb.org/extlink&oid=109239629&loc=SL4573702-111684 Reference 5: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 22 -URI http://asc.fasb.org/extlink&oid=115929826&loc=d3e8736-108599 Reference 6: http://www.xbrl.org/2003/role/exampleRef -Publisher FASB -Name Accounting Standards Codification -Topic 810 -SubTopic 10 -Section 55 -Paragraph 4J -URI http://asc.fasb.org/extlink&oid=84234705&loc=SL4591551-111686 Reference 7: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 2 -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3000-108585 Reference 8: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 810 -SubTopic 10 -Section 45 -Paragraph 19 -URI http://asc.fasb.org/extlink&oid=108774443&loc=SL4569616-111683 Reference 9: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 32 -Subparagraph (c) -URI http://asc.fasb.org/extlink&oid=115929826&loc=d3e8933-108599 Reference 10: http://www.xbrl.org/2003/role/exampleRef -Publisher FASB -Name Accounting Standards Codification -Topic 810 -SubTopic 10 -Section 55 -Paragraph 4K -URI http://asc.fasb.org/extlink&oid=84234705&loc=SL4591552-111686 + Details
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- Definition The cash outflow for debt initially having maturity due after one year or beyond the normal operating cycle, if longer. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 15 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3291-108585 + Details
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- Definition The aggregate amount of noncash, equity-based employee remuneration. This may include the value of stock or unit options, amortization of restricted stock or units, and adjustment for officers' compensation. As noncash, this element is an add back when calculating net cash generated by operating activities using the indirect method. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 28 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3602-108585 + Details
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