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CONDENSED CONSOLIDATED STATEMENT OF CASH FLOWS - USD ($)
$ in Millions
 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Cash Flows from Operating Activities    
Net income $ 15,301 $ 13,389
Adjustments to reconcile net income to net cash provided by operating activities:    
Amortization 1,820 1,720
Depreciation 1,552 1,582
Income from investments in equity securities, net (563) (169)
Charges for research and development asset acquisitions 0 2,756
Deferred income taxes (846) (633)
Share-based compensation 615 574
Other 393 611
Net changes in assets and liabilities (4,657) (1,812)
Net Cash Provided by Operating Activities 13,615 18,018
Cash Flows from Investing Activities    
Capital expenditures (3,079) (2,435)
Purchases of securities and other investments (1,207) (64)
Proceeds from sales of securities and other investments 1,632 370
Acquisition of Eyebiotech Limited, net of cash acquired 0 (1,344)
Acquisition of Elanco Animal Health Incorporated aqua business 0 (1,301)
Acquisition of Harpoon Therapeutics, Inc., net of cash acquired 0 (746)
Acquisition of MK-1045 (formerly CN201) from Curon Pharmaceutical 0 (700)
Other 114 (70)
Net Cash Used in Investing Activities (2,540) (6,290)
Cash Flows from Financing Activities    
Net change in short-term borrowings 63 0
Proceeds from issuance of debt 5,962 3,599
Payments on debt (2,501) (751)
Dividends paid to stockholders (6,158) (5,889)
Purchases of treasury stock (3,832) (817)
Proceeds from exercise of stock options 45 165
Other (252) (330)
Net Cash Used in Financing Activities (6,673) (4,023)
Effect of Exchange Rate Changes on Cash, Cash Equivalents and Restricted Cash 540 74
Net Increase in Cash, Cash Equivalents and Restricted Cash 4,942 7,779
Cash, Cash Equivalents and Restricted Cash at Beginning of Year (includes restricted cash of $76 and $68 at January 1, 2025 and 2024, respectively, included in Other current assets) 13,318 6,909
Cash, Cash Equivalents and Restricted Cash at End of Period (includes restricted cash of $91 and $95 at September 30, 2025 and 2024, respectively, included in Other current assets) $ 18,260 $ 14,688