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Income Taxes (Tables)

12 Months Ended

Dec. 31, 2020

Income Tax Disclosure [Abstract]

Schedule of Components of Income Tax Expense

Following is the composition of income tax expense:

			2020						2019						2018
Current:
Federal(1)			$	567.6					$	280.2					$	169.6
Foreign			650.4						299.8						106.8
State			(47.3)						(14.4)						4.7
Total current tax expense			1,170.7						565.6						281.1
Deferred:
Federal(2)			(97.4)						141.3						(3.7)
Foreign			(16.6)						(24.1)						248.7
State			(20.5)						(54.8)						3.4
Total deferred tax (benefit) expense			(134.5)						62.4						248.4
Income taxes			$	1,036.2					$	628.0					$	529.5

(1) The 2020 and 2019 current tax expense includes $144.4 million and $153.1 million of tax benefit, respectively, from utilization of net operating loss and tax credit carryforwards. The 2018 current tax expense includes $201.5 million of tax expense related to effects of the 2017 Tax Act.

(2) The 2018 deferred tax benefit includes $26.2 million of tax benefit related to effects of the 2017 Tax Act.

Schedule of Deferred Tax Assets and Liabilities

Significant components of our deferred tax assets and liabilities as of December 31 were as follows:

			2020						2019
Deferred tax assets:
Purchases of intangible assets			$	2,560.6					$	2,512.4
Compensation and benefits			1,045.6						934.3
Tax credit carryforwards and carrybacks			523.5						455.8
Tax loss carryforwards and carrybacks			488.3						318.8
Sales rebates and discounts			461.3						197.3
Correlative tax adjustments			404.2						219.1
Foreign tax redeterminations			242.8						156.8
Operating lease liabilities			150.7						140.6
Capitalized research and development			135.2						75.7
Other			605.8						595.7
Total gross deferred tax assets			6,618.0						5,606.5
Valuation allowances			(816.3)						(616.5)
Total deferred tax assets			5,801.7						4,990.0
Deferred tax liabilities:
Earnings of foreign subsidiaries			(1,905.3)						(1,776.4)
Intangibles			(1,465.7)						(1,298.0)
Inventories			(623.7)						(686.4)
Prepaid employee benefits			(410.1)						(305.9)
Property and equipment			(315.2)						(274.1)
Financial instruments			(216.9)						(139.4)
Operating lease assets			(134.3)						(124.7)
Total deferred tax liabilities			(5,071.2)						(4,604.9)
Deferred tax assets - net			$	730.5					$	385.1

Schedule of Cash Payments Relating to Income Taxes and Tax Act Toll Tax

Cash payments of U.S. federal, state, and foreign income taxes, net of refunds, were as follows:

			2020						2019						2018
Cash payments of income taxes			$	954.6					$	1,180.5					$	1,076.7

Having made this election, our future cash payments relating to the Toll Tax as of December 31, 2020 are as follows:

			Total			Less than 1 Year			1-3 Years			3-5 Years
2017 Tax Act Toll Tax			$2,403.1			$253.7			$729.3			$1,420.1

Schedule of Effective Income Tax Rate Reconciliation

Following is a reconciliation of the consolidated income tax expense applying the U.S. federal statutory rate to income before income taxes to reported consolidated income tax expense:

			2020						2019						2018
Income tax at the U.S. federal statutory tax rate			$	1,518.3					$	1,105.8					$	772.8
Add (deduct):
International operations, including Puerto Rico			(297.1)						(242.0)						(627.1)
General business credits			(97.9)						(108.8)						(87.4)
Non-deductible acquired IPR&D(1)			63.2						—						309.9
2017 Tax Act			—						—						175.3
Other			(150.3)						(127.0)						(14.0)
Income taxes			$	1,036.2					$	628.0					$	529.5

(1) Non-deductible acquired IPR&D was related to the acquisitions of Disarm and a pre-clinical stage company in 2020 and ARMO in 2018. See Note 3 for additional information related to acquisitions.

Summary of Income Tax Contingencies

A reconciliation of the beginning and ending amount of gross unrecognized tax benefits is as follows:

			2020						2019						2018
Beginning balance at January 1			$	2,108.6					$	2,034.6					$	1,000.8
Additions based on tax positions related to the current year			225.6						187.2						798.2
Additions for tax positions of prior years			310.8						425.3						410.9
Reductions for tax positions of prior years			(52.4)						(100.3)						(115.4)
Settlements			(72.0)						(260.5)						(33.2)
Lapses of statutes of limitation			(41.7)						(161.5)						(20.5)
Changes related to the impact of foreign currency translation			73.0						(16.2)						(6.2)
Ending balance at December 31			$	2,551.9					$	2,108.6					$	2,034.6

We recognize both accrued interest and penalties related to unrecognized tax benefits in income tax expense. We recognized income tax (benefit) expense related to interest and penalties as follows:

			2020						2019						2018
Income tax (benefit) expense			$	34.0					$	(26.4)					$	25.1

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