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Segment Reporting - Reconciliation of Segment Profits to Income before Taxes (Details) - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2025
Mar. 31, 2024
Segment Reporting Information [Line Items]    
Sales $ 15,529 $ 15,775
Less segment costs:    
Cost of sales 3,419 3,540
Selling, general and administrative 2,552 2,483
Research and development (3,621) (3,992)
Other segment items 35 33
Total segment profits 5,903 5,670
Other profits 5,903 5,670
Unallocated:    
Interest income 109 73
Interest expense (313) (303)
Amortization (597) (473)
Depreciation (502) (511)
Research and development (3,621) (3,992)
Restructuring costs (69) (123)
Total segment profits    
Segment Reporting Information [Line Items]    
Sales 15,226 15,517
Less segment costs:    
Total segment profits 11,346 11,459
Other profits 11,346 11,459
Unallocated:    
Depreciation (61) (59)
Total segment profits | Pharmaceutical    
Segment Reporting Information [Line Items]    
Sales 13,638 14,006
Less segment costs:    
Cost of sales 1,573 1,706
Selling, general and administrative 1,402 1,429
Research and development 0 0
Other segment items (49) (33)
Total segment profits 10,712 10,904
Other profits 10,712 10,904
Unallocated:    
Depreciation (1) (1)
Research and development 0 0
Total segment profits | Animal Health    
Segment Reporting Information [Line Items]    
Sales 1,588 1,511
Less segment costs:    
Cost of sales 600 613
Selling, general and administrative 260 252
Research and development (95) (90)
Other segment items (1) 1
Total segment profits 634 555
Other profits 634 555
Unallocated:    
Depreciation (60) (58)
Research and development (95) (90)
Other profits    
Segment Reporting Information [Line Items]    
Sales 303 258
Less segment costs:    
Research and development (3,477) (3,851)
Total segment profits 202 146
Other profits 202 146
Unallocated:    
Interest income 109 73
Interest expense (313) (303)
Amortization (597) (473)
Depreciation (441) (452)
Research and development (3,477) (3,851)
Restructuring costs (69) (123)
Other unallocated, net $ (857) $ (806)