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Financial Instruments (Tables) | 12 Months Ended
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Dec. 31, 2023
Derivative Instruments and Hedging Activities Disclosure [Abstract] |
Effect of Net Investment Hedges | The effects of the Company’s net investment hedges on OCI and the Consolidated Statement of Income are shown below:
| Amount of Pretax (Gain) Loss Recognized in Other Comprehensive Income (1) |  | Amount of Pretax (Gain) Loss Recognized in Other (income) expense, net for Amounts Excluded from Effectiveness Testing
Years Ended December 31 | 2023 |  | 2022 |  | 2021 |  | 2023 |  | 2022 |  | 2021
Net Investment Hedging Relationships |  |  |  |  |  |  |  |  |  |  |
Foreign exchange contracts | $ | — |  |  | $ | (48) |  |  | $ | (49) |  |  | $ | 1 |  |  | $ | (1) |  |  | $ | (13) |
Euro-denominated notes | 105 |  |  | (162) |  |  | (296) |  |  | — |  |  | — |  |  | — |
(1) No amounts were reclassified from AOCL into income related to the sale of a subsidiary.
Summary of Interest Rate Derivatives | At December 31, 2023, the Company was a party to four pay-floating, receive-fixed interest rate swap contracts designated as fair value hedges of a portion of fixed-rate notes as detailed in the table below.
| Par Value of Debt |  | Number of Interest Rate Swaps Held |  | Total Swap Notional Amount
4.50% notes due 2033 | $ | 1,500 |  |  | 4 |  |  | $ | 1,000 |
Schedule of Fair Value Hedging Instruments, Statements of Financial Performance and Financial Position | The table below presents the location of amounts recorded in the Consolidated Balance Sheet related to cumulative basis adjustments for fair value hedges as of December 31:
| Carrying Amount of Hedged Liabilities |  | Cumulative Amount of Fair Value Hedging Adjustment Increase (Decrease) Included in the Carrying Amount
| 2023 |  | 2022 |  | 2023 |  | 2022
Balance Sheet Caption |  |  |  |  |  |  |
Long-Term Debt | $ | 1,056 |  |  | $ | — |  |  | $ | 56 |  |  | $ | — |
Fair Value of Derivatives on a Gross Basis Segregated Between those Derivatives that are Designated as Hedging Instruments and those that are Not Designated as Hedging Instruments | Presented in the table below is the fair value of derivatives on a gross basis segregated between those derivatives that are designated as hedging instruments and those that are not designated as hedging instruments as of December 31:
|  |  | 2023 |  | 2022
|  |  | Fair Value of Derivative |  | U.S. Dollar Notional |  | Fair Value of Derivative |  | U.S. Dollar Notional
|  |  | Asset |  | Liability |  | Asset |  | Liability |
Derivatives Designated as Hedging Instruments | Balance Sheet Caption |  |  |  |  |  |  |  |  |  |  |  |
Interest rate swap contracts | Other Noncurrent Assets |  | $ | 57 |  |  | $ | — |  |  | $ | 1,000 |  |  | $ | — |  |  | $ | — |  |  | $ | — |
Foreign exchange contracts | Other current assets |  | 106 |  |  | — |  |  | 6,138 |  |  | 220 |  |  | — |  |  | 4,824 |
Foreign exchange contracts | Other Assets |  | 26 |  |  | — |  |  | 1,929 |  |  | 27 |  |  | — |  |  | 1,609 |
Foreign exchange contracts | Accrued and other current liabilities |  | — |  |  | 76 |  |  | 3,680 |  |  | — |  |  | 101 |  |  | 2,691 |
Foreign exchange contracts | Other Noncurrent Liabilities |  | — |  |  | 1 |  |  | 7 |  |  | — |  |  | 1 |  |  | 91 |
|  |  | $ | 189 |  |  | $ | 77 |  |  | $ | 12,754 |  |  | $ | 247 |  |  | $ | 102 |  |  | $ | 9,215 |
Derivatives Not Designated as Hedging Instruments | Balance Sheet Caption |  |  |  |  |  |  |  |  |  |  |  |
Foreign exchange contracts | Other current assets |  | $ | 153 |  |  | $ | — |  |  | $ | 9,693 |  |  | $ | 186 |  |  | $ | — |  |  | $ | 8,540 |
Foreign exchange contracts | Accrued and other current liabilities |  | — |  |  | 162 |  |  | 8,104 |  |  | — |  |  | 307 |  |  | 10,926 |
|  |  | $ | 153 |  |  | $ | 162 |  |  | $ | 17,797 |  |  | $ | 186 |  |  | $ | 307 |  |  | $ | 19,466 |
|  |  | $ | 342 |  |  | $ | 239 |  |  | $ | 30,551 |  |  | $ | 433 |  |  | $ | 409 |  |  | $ | 28,681 |
Information on Derivative Positions Subject to Master Netting Arrangements as if they were Presented on a Net Basis | The following table provides information on the Company’s derivative positions subject to these master netting arrangements as if they were presented on a net basis, allowing for the right of offset by counterparty and cash collateral exchanged per the master agreements and related credit support annexes at December 31:
| 2023 |  | 2022
| Asset |  | Liability |  | Asset |  | Liability
Gross amounts recognized in the consolidated balance sheet | $ | 342 |  |  | $ | 239 |  |  | $ | 433 |  |  | $ | 409 |
Gross amounts subject to offset in master netting arrangements not offset in the consolidated balance sheet | (215) |  |  | (215) |  |  | (220) |  |  | (220) |
Cash collateral received/posted | (3) |  |  | — |  |  | (66) |  |  | (19) |
Net amounts | $ | 124 |  |  | $ | 24 |  |  | $ | 147 |  |  | $ | 170 |
Location and Pretax Gain or Loss Amounts for Derivatives | The table below provides information regarding the location and amount of pretax gains and losses of derivatives designated in fair value or cash flow hedging relationships:
Years Ended December 31 | 2023 |  | 2022 |  | 2021 |  | 2023 |  | 2022 |  | 2021 |  | 2023 |  | 2022 |  | 2021
Financial Statement Caption in which Effects of Fair Value or Cash Flow Hedges are Recorded | Sales |  | Other (income) expense, net (1) |  | Other comprehensive income (loss)
| $ | 60,115 |  |  | $ | 59,283 |  |  | $ | 48,704 |  |  | $ | 466 |  |  | $ | 1,501 |  |  | $ | (1,341) |  |  | $ | (393) |  |  | $ | (339) |  |  | $ | 1,756 |
Loss (gain) on fair value hedging relationships: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Interest rate swap contracts |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Hedged items | — |  |  | — |  |  | — |  |  | 56 |  |  | (13) |  |  | (40) |  |  | — |  |  | — |  |  | — |
Derivatives designated as hedging instruments | — |  |  | — |  |  | — |  |  | (57) |  |  | 4 |  |  | 1 |  |  | — |  |  | — |  |  | — |
Impact of cash flow hedging relationships: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Foreign exchange contracts |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Amount of gain recognized in OCI on derivatives | — |  |  | — |  |  | — |  |  | — |  |  | — |  |  | — |  |  | 114 |  |  | 684 |  |  | 333 |
Increase (decrease) in Sales as a result of AOCL reclassifications | 249 |  |  | 773 |  |  | (194) |  |  | — |  |  | — |  |  | — |  |  | (249) |  |  | (773) |  |  | 194 |
Interest rate contracts |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Amount of gain recognized in Other (income) expense, net on derivatives | — |  |  | — |  |  | — |  |  | (1) |  |  | (2) |  |  | (2) |  |  | — |  |  | — |  |  | — |
Amount of gain (loss) recognized in OCI on derivatives | — |  |  | — |  |  | — |  |  | — |  |  | — |  |  | — |  |  | 13 |  |  | (2) |  |  | (2) |
(1) Interest expense is a component of Other (income) expense, net.
Income Statement Effects of Derivatives Not Designated as Hedging Instruments | The table below provides information regarding the income statement effects of derivatives not designated as hedging instruments:
|  |  | Amount of Derivative Pretax (Gain) Loss Recognized in Income
Years Ended December 31 |  |  | 2023 |  | 2022 |  | 2021
Derivatives Not Designated as Hedging Instruments | Income Statement Caption |  |  |  |  |  |
Foreign exchange contracts (1) | Other (income) expense, net |  | $ | (6) |  |  | $ | (49) |  |  | $ | 313 |
Foreign exchange contracts (2) | Sales |  | 5 |  |  | (37) |  |  | 9 |
(1) These derivative contracts primarily mitigate changes in the value of remeasured foreign currency denominated monetary assets and liabilities attributable to changes in foreign currency exchange rates. Amount in 2021 includes a loss on forward exchange contracts entered into in conjunction with the spin-off of Organon. (2) These derivative contracts serve as economic hedges of forecasted transactions.
Information on Investments in Debt and Equity Securities | Information on investments in debt and equity securities at December 31 is as follows:
| 2023 |  | 2022
| Amortized Cost |  | Gross Unrealized |  | Fair Value |  | Amortized Cost |  | Gross Unrealized |  | Fair Value
| Gains |  | Losses |  | Gains |  | Losses |
Commercial paper | $ | 252 |  |  | $ | — |  |  | $ | — |  |  | $ | 252 |  |  | $ | 498 |  |  | $ | — |  |  | $ | — |  |  | $ | 498 |
U.S. government and agency securities | 72 |  |  | — |  |  | — |  |  | 72 |  |  | 68 |  | — |  |  | — |  |  | 68 |
Corporate notes and bonds | 13 |  |  | — |  |  | — |  |  | 13 |  |  | 3 |  |  | — |  |  | — |  |  | 3 |
Total debt securities | $ | 337 |  |  | $ | — |  |  | $ | — |  |  | $ | 337 |  |  | $ | 569 |  |  | $ | — |  |  | $ | — |  |  | $ | 569 |
Publicly traded equity securities (1) |  |  |  |  |  |  | 764 |  |  |  |  |  |  |  |  | 1,284 |
Total debt and publicly traded equity securities |  |  |  |  |  |  | $ | 1,101 |  |  |  |  |  |  |  |  | $ | 1,853 |
(1) Unrealized net gains of $411 million were recorded in Other (income) expense, net in 2023 on equity securities still held at December 31, 2023. Unrealized net losses of $462 million were recorded in Other (income) expense, net in 2022 on equity securities still held at December 31, 2022.
Financial Assets and Liabilities Measured at Fair Value on a Recurring Basis | Financial assets and liabilities measured at fair value on a recurring basis at December 31 are summarized below:
| Fair Value Measurements Using |  | Fair Value Measurements Using
| Level 1 |  | Level 2 |  | Level 3 |  | Total |  | Level 1 |  | Level 2 |  | Level 3 |  | Total
| 2023 |  | 2022
Assets |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Investments |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Commercial paper | $ | — |  |  | $ | 252 |  |  | $ | — |  |  | $ | 252 |  |  | $ | — |  |  | $ | 498 |  |  | $ | — |  |  | $ | 498 |
Publicly traded equity securities | 252 |  |  | — |  |  | — |  |  | 252 |  |  | 1,015 |  |  | — |  |  | — |  |  | 1,015 |
| 252 |  |  | 252 |  |  | — |  |  | 504 |  |  | 1,015 |  |  | 498 |  |  | — |  |  | 1,513 |
Other assets (1) |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
U.S. government and agency securities | 72 |  |  | — |  |  | — |  |  | 72 |  |  | 68 |  |  | — |  |  | — |  |  | 68 |
Corporate notes and bonds | 13 |  |  | — |  |  | — |  |  | 13 |  |  | 3 |  |  | — |  |  | — |  |  | 3 |
Publicly traded equity securities (2) | 512 |  |  | — |  |  | — |  |  | 512 |  |  | 269 |  |  | — |  |  | — |  |  | 269 |
| 597 |  |  | — |  |  | — |  |  | 597 |  |  | 340 |  |  | — |  |  | — |  |  | 340 |
Derivative assets (3) |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Forward exchange contracts | — |  |  | 202 |  |  | — |  |  | 202 |  |  | — |  |  | 218 |  |  | — |  |  | 218 |
Purchased currency options | — |  |  | 83 |  |  | — |  |  | 83 |  |  | — |  |  | 215 |  |  | — |  |  | 215 |
Interest rate swaps | — |  |  | 57 |  |  | — |  |  | 57 |  |  | — |  |  | — |  |  | — |  |  | — |
| — |  |  | 342 |  |  | — |  |  | 342 |  |  | — |  |  | 433 |  |  | — |  |  | 433 |
Total assets | $ | 849 |  |  | $ | 594 |  |  | $ | — |  |  | $ | 1,443 |  |  | $ | 1,355 |  |  | $ | 931 |  |  | $ | — |  |  | $ | 2,286 |
Liabilities |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Other liabilities |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Contingent consideration | $ | — |  |  | $ | — |  |  | $ | 354 |  |  | $ | 354 |  |  | $ | — |  |  | $ | — |  |  | $ | 456 |  |  | $ | 456 |
Derivative liabilities (3) |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Forward exchange contracts | — |  |  | 239 |  |  | — |  |  | 239 |  |  | — |  |  | 402 |  |  | — |  |  | 402 |
Written currency options | — |  |  | — |  |  | — |  |  | — |  |  | — |  |  | 7 |  |  | — |  |  | 7 |
| — |  |  | 239 |  |  | — |  |  | 239 |  |  | — |  |  | 409 |  |  | — |  |  | 409 |
Total liabilities | $ | — |  |  | $ | 239 |  |  | $ | 354 |  |  | $ | 593 |  |  | $ | — |  |  | $ | 409 |  |  | $ | 456 |  |  | $ | 865 |
(1) Investments included in other assets are restricted as to use, including for the payment of benefits under employee benefit plans. (2) Balance at December 31, 2023 includes securities with a total fair value of $177 million, which are subject to a contractual sale restriction that expires in July 2024. (3) The fair value determination of derivatives includes the impact of the credit risk of counterparties to the derivatives and the Company’s own credit risk, the effects of which were not significant.
Summarized Information about the Changes in Liabilities for Contingent Consideration | Summarized information about the changes in the fair value of liabilities for contingent consideration associated with business combinations is as follows:
| 2023 |  | 2022
Fair value January 1 | $ | 456 |  |  | $ | 777 |
Changes in estimated fair value (1) | 15 |  |  | (146) |
Payments | (117) |  |  | (119) |
Other | — |  |  | (56) |
Fair value December 31 (2) | $ | 354 |  |  | $ | 456 |
(1) Recorded in Cost of sales, Research and development expenses, and Other (income) expense, net. Includes cumulative translation adjustments. (2) At December 31, 2023 and 2022, $263 million and $368 million, respectively, of the liabilities relate to the termination of the Sanofi Pasteur MSD joint venture in 2016. As part of the termination, Merck recorded a liability for contingent future royalty payments of 11.5% on net sales of all Merck products that were previously sold by the joint venture through December 31, 2024. The fair value of this liability is determined utilizing the estimated amount and timing of projected cash flows using a risk-adjusted discount rate to present value the cash flows. Balance at December 31, 2023 includes $128 million recorded as a current liability for amounts expected to be paid within the next 12 months.

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