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Consolidated Statements of Cash Flows - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Cash Flows from Operating Activities      
Net income $ 6,193.7 $ 8,318.4 $ 3,232.0
Adjustments to Reconcile Net Income to Cash Flows from Operating Activities:      
Gain related to disposition of Elanco (Note 19) 0.0 (3,680.5) 0.0
Gain on sale of antibiotic business in China (Note 3) 0.0 (309.8) 0.0
Depreciation and amortization 1,323.9 1,232.6 1,609.0
Change in deferred income taxes (134.5) 62.4 326.8
Stock-based compensation expense 308.1 312.4 279.5
Net investment gains (1,438.5) (403.1) (27.0)
Acquired in-process research and development (Note 3) 660.4 239.6 1,983.9
Other non-cash operating activities, net 333.9 751.8 499.0
Other changes in operating assets and liabilities, net of acquisitions and divestitures:      
Receivables—(increase) decrease (1,350.2) (127.2) (996.7)
Inventories—(increase) decrease (533.4) (258.7) 7.8
Other assets—(increase) decrease (457.1) (602.3) (980.0)
Income taxes payable—increase (decrease) 322.0 (221.3) (125.3)
Accounts payable and other liabilities—increase (decrease) 1,271.3 (477.7) (284.5)
Net Cash Provided by Operating Activities 6,499.6 4,836.6 5,524.5
Cash Flows from Investing Activities      
Purchases of property and equipment (1,387.9) (1,033.9) (1,210.6)
Proceeds from sales and maturities of short-term investments 129.7 136.6 2,552.5
Purchases of short-term investments (11.4) (42.7) (112.2)
Proceeds from sales of noncurrent investments 757.1 609.8 3,509.5
Purchases of noncurrent investments (358.7) (247.5) (837.9)
Purchases of in-process research and development (641.2) (319.6) (1,807.6)
Cash paid for acquisitions, net of cash acquired (Note 3) (849.3) (6,917.7) 0.0
Cash distributed to Elanco upon disposition 0.0 (374.0) 0.0
Cash received for sale of antibiotic business in China 0.0 354.8 0.0
Other investing activities, net 102.8 (248.7) (187.7)
Net Cash Provided by (Used for) Investing Activities (2,258.9) (8,082.9) 1,906.0
Cash Flows from Financing Activities      
Dividends paid (2,687.1) (2,409.8) (2,311.8)
Net change in short-term borrowings (1,494.2) 995.4 (2,197.9)
Proceeds from issuance of long-term debt 2,062.3 6,556.4 2,477.7
Repayments of long-term debt (276.5) (2,866.4) (1,009.1)
Purchases of common stock (500.0) (4,400.0) (4,150.7)
Net proceeds from Elanco initial public offering (Note 19) 0.0 0.0 1,659.7
Other financing activities, net (241.6) (200.1) (372.8)
Net Cash Used for Financing Activities (3,137.1) (2,324.5) (5,904.9)
Effect of exchange rate changes on cash and cash equivalents 216.0 (89.9) (63.6)
Net increase (decrease) in cash and cash equivalents 1,319.6 (5,660.7) 1,462.0
Cash and cash equivalents at beginning of year (includes $677.5 (2019) and $324.4 (2018) of discontinued operations) 2,337.5 7,998.2 6,536.2
Cash and Cash Equivalents at End of Year (includes $677.5 (2018) of discontinued operations) $ 3,657.1 $ 2,337.5 $ 7,998.2