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CONDENSED CONSOLIDATED STATEMENT OF CASH FLOWS - USD ($)
$ in Millions
 9 Months Ended
Sep. 30, 2024
Sep. 30, 2023
Cash Flows from Operating Activities    
Net income $ 13,389 $ 1,603
Adjustments to reconcile net income to net cash provided by operating activities:    
Amortization 1,720 1,582
Depreciation 1,582 1,326
Income from investments in equity securities, net (169) (240)
Charge for the acquisition of Eyebiotech Limited 1,350 0
Charge for the acquisition of MK-1045 (formerly CN201) from Curon Pharmaceutical 750 0
Charge for the acquisition of Harpoon Therapeutics, Inc. 656 0
Charge for the acquisition of Prometheus Biosciences, Inc. 0 10,217
Charge for the acquisition of Imago BioSciences, Inc. 0 1,192
Deferred income taxes (633) (968)
Share-based compensation 574 478
Other 611 (81)
Net changes in assets and liabilities (1,812) (2,349)
Net Cash Provided by Operating Activities 18,018 12,760
Cash Flows from Investing Activities    
Capital expenditures (2,435) (2,874)
Purchases of securities and other investments (64) (704)
Proceeds from sales of securities and other investments 370 1,489
Acquisition of Eyebiotech Limited, net of cash acquired (1,344) 0
Acquisition of Elanco Animal Health Incorporated aqua business (1,301) 0
Acquisition of Harpoon Therapeutics, Inc., net of cash acquired (746) 0
Acquisition of MK-1045 (formerly CN201) from Curon Pharmaceutical (700) 0
Acquisition of Prometheus Biosciences, Inc., net of cash acquired 0 (10,705)
Acquisition of Imago BioSciences, Inc., net of cash acquired 0 (1,327)
Other (70) (15)
Net Cash Used in Investing Activities (6,290) (14,136)
Cash Flows from Financing Activities    
Proceeds from issuance of debt 3,599 5,939
Payments on debt (751) (1,752)
Dividends paid to stockholders (5,889) (5,593)
Purchases of treasury stock (817) (953)
Proceeds from exercise of stock options 165 119
Other (330) (325)
Net Cash Used in Financing Activities (4,023) (2,565)
Effect of Exchange Rate Changes on Cash, Cash Equivalents and Restricted Cash 74 (163)
Net Increase (Decrease) in Cash, Cash Equivalents and Restricted Cash 7,779 (4,104)
Cash, Cash Equivalents and Restricted Cash at Beginning of Year (includes restricted cash of $68 and $79 at January 1, 2024 and 2023, respectively, included in Other current assets) 6,909 12,773
Cash, Cash Equivalents and Restricted Cash at End of Period (includes restricted cash of $95 and $64 at September 30, 2024 and 2023, respectively, included in Other current assets) $ 14,688 $ 8,669