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Consolidated Statement of Cash Flows - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2019
Dec. 31, 2018
Dec. 31, 2017
Cash Flows from Operating Activities      
Net income $ 9,777 $ 6,193 $ 2,418
Adjustments to reconcile net income to net cash provided by operating activities:      
Depreciation and amortization 3,652 4,519 4,676
Intangible asset impairment charges 1,040 296 646
Charge for the acquisition of Peloton Therapeutics, Inc. 993 0 0
Charge for future payments related to collaboration license options 0 650 500
Provisional charge for one-time transition tax related to the enactment of U.S. tax legislation 0 0 5,347
Deferred income taxes (556) (509) (2,621)
Share-based compensation 417 348 312
Other 184 978 190
Net changes in assets and liabilities:      
Accounts receivable 294 (418) 297
Inventories (508) (911) (145)
Trade accounts payable 399 230 254
Accrued and other current liabilities 376 (341) (922)
Income taxes payable (2,359) 827 (3,291)
Noncurrent liabilities (237) (266) (123)
Other (32) (674) (1,087)
Net Cash Provided by Operating Activities 13,440 10,922 6,451
Cash Flows from Investing Activities      
Capital expenditures (3,473) (2,615) (1,888)
Purchases of securities and other investments (3,202) (7,994) (10,739)
Proceeds from sales of securities and other investments 8,622 15,252 15,664
Acquisition of Antelliq Corporation, net of cash acquired (3,620) 0 0
Acquisition of Peloton Therapeutics, Inc., net of cash acquired (1,040) 0 0
Other acquisitions, net of cash acquired (294) (431) (396)
Other 378 102 38
Net Cash (Used in) Provided by Investing Activities (2,629) 4,314 2,679
Cash Flows from Financing Activities      
Net change in short-term borrowings (3,710) 5,124 (26)
Payments on debt 0 (4,287) (1,103)
Proceeds from issuance of debt 4,958 0 0
Purchases of treasury stock (4,780) (9,091) (4,014)
Dividends paid to stockholders (5,695) (5,172) (5,167)
Proceeds from exercise of stock options 361 591 499
Other 5 (325) (195)
Net Cash Used in Financing Activities (8,861) (13,160) (10,006)
Effect of Exchange Rate Changes on Cash, Cash Equivalents and Restricted Cash 17 (205) 457
Net Increase (Decrease) in Cash, Cash Equivalents and Restricted Cash 1,967 1,871 (419)
Cash, Cash Equivalents and Restricted Cash at Beginning of Year (includes $2 million of restricted cash at January 1, 2019 included in Other Assets) 7,967 6,096 6,515
Cash, Cash Equivalents and Restricted Cash at End of Year (includes $258 million of restricted cash at December 31, 2019 included in Other Assets - see Note 6) $ 9,934 $ 7,967 $ 6,096