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Segment Reporting - Reconciliation of Segment Profits to Income before Taxes (Details) - USD ($)
$ in Millions
 3 Months Ended 6 Months Ended
Jun. 30, 2025
Jun. 30, 2024
Jun. 30, 2025
Jun. 30, 2024
Segment Reporting Information [Line Items]        
Sales $ 15,806 $ 16,112 $ 31,335 $ 31,887
Less segment costs:        
Cost of sales 3,557 3,745 6,976 7,285
Selling, general and administrative 2,649 2,739 5,202 5,221
Research and development (4,048) (3,500) (7,669) (7,492)
Other segment items 7 (42) 43 (12)
Total segment profits 4,999 6,006 10,902 11,675
Other profits 4,999 6,006 10,902 11,675
Unallocated:        
Interest income 69 69 178 141
Interest expense (305) (310) (618) (613)
Amortization     (1,198) (1,087)
Depreciation     (1,020) (1,029)
Research and development (4,048) (3,500) (7,669) (7,492)
Restructuring costs (560) (80) (629) (202)
Total segment profits        
Segment Reporting Information [Line Items]        
Sales 15,696 15,890 30,922 31,408
Less segment costs:        
Total segment profits 11,607 11,708 22,952 23,168
Other profits 11,607 11,708 22,952 23,168
Unallocated:        
Depreciation (63) (68) (124) (127)
Total segment profits | Pharma- ceutical        
Segment Reporting Information [Line Items]        
Sales 14,050 14,408 27,688 28,415
Less segment costs:        
Cost of sales 1,601 1,708 3,174 3,414
Selling, general and administrative 1,456 1,514 2,858 2,943
Research and development 0 0 0 0
Other segment items (21) (14) (70) (46)
Total segment profits 11,014 11,200 21,726 22,104
Other profits 11,014 11,200 21,726 22,104
Unallocated:        
Depreciation (1) (1) (2) (2)
Research and development 0 0 0 0
Total segment profits | Animal Health        
Segment Reporting Information [Line Items]        
Sales 1,646 1,482 3,234 2,993
Less segment costs:        
Cost of sales 659 612 1,258 1,225
Selling, general and administrative 284 270 544 523
Research and development (110) (91) (205) (181)
Other segment items 0 1 1 0
Total segment profits 593 508 1,226 1,064
Other profits 593 508 1,226 1,064
Unallocated:        
Depreciation (62) (67) (122) (125)
Research and development (110) (91) (205) (181)
Other profits        
Segment Reporting Information [Line Items]        
Sales 110 222 413 479
Less segment costs:        
Research and development (3,844) (3,360) (7,321) (7,209)
Total segment profits 30 129 231 274
Other profits 30 129 231 274
Unallocated:        
Interest income 69 69 178 141
Interest expense (305) (310) (618) (613)
Amortization (601) (614) (1,198) (1,087)
Depreciation (455) (450) (896) (902)
Research and development (3,844) (3,360) (7,321) (7,209)
Restructuring costs (560) (80) (629) (202)
Other unallocated, net $ (942) $ (1,086) $ (1,797) $ (1,895)