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Consolidated Statements of Cash Flows - USD ($) $ in Millions | 12 Months Ended
--- | ---
Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019
Cash Flows from Operating Activities |  |  |
Net income | $ 5,581.7 | $ 6,193.7 | $ 8,318.4
Adjustments to Reconcile Net Income to Cash Flows from Operating Activities: |  |  |
Gain related to disposition of Elanco (Note 19) | 0.0 | 0.0 | (3,680.5)
Gain on sale of antibiotic business in China (Note 3) | 0.0 | 0.0 | (309.8)
Depreciation and amortization | 1,547.6 | 1,323.9 | 1,232.6
Debt extinguishment loss (Note 11) | 405.2 | 0.0 | 252.5
Change in deferred income taxes | (802.3) | (134.5) | 62.4
Stock-based compensation expense | 342.8 | 308.1 | 312.4
Net investment gains | (178.0) | (1,438.5) | (403.1)
Acquired in-process research and development (Note 3) | 874.9 | 660.4 | 239.6
Other non-cash operating activities, net | 511.4 | 333.9 | 499.3
Other changes in operating assets and liabilities, net of acquisitions and divestitures: |  |  |
Receivables—(increase) decrease | (1,278.3) | (1,350.2) | (127.2)
Inventories—(increase) decrease | (235.9) | (533.4) | (258.7)
Other assets—(increase) decrease | 1,515.4 | (457.1) | (602.3)
Income taxes payable—increase (decrease) | (359.7) | 322.0 | (221.3)
Accounts payable and other liabilities—increase (decrease) | (664.1) | 1,271.3 | (477.7)
Net Cash Provided by Operating Activities | 7,260.7 | 6,499.6 | 4,836.6
Cash Flows from Investing Activities |  |  |
Purchases of property and equipment | (1,309.8) | (1,387.9) | (1,033.9)
Proceeds from sales and maturities of short-term investments | 47.4 | 129.7 | 136.6
Purchases of short-term investments | (83.5) | (11.4) | (42.7)
Proceeds from sales of noncurrent investments | 800.0 | 757.1 | 609.8
Purchases of noncurrent investments | (929.9) | (358.7) | (247.5)
Purchases of in-process research and development | (563.4) | (641.2) | (319.6)
Cash paid for acquisitions, net of cash acquired (Note 3) | (747.4) | (849.3) | (6,917.7)
Cash distributed to Elanco upon disposition | 0.0 | 0.0 | (374.0)
Cash received for sale of antibiotic business in China | 0.0 | 0.0 | 354.8
Other investing activities, net | 24.3 | 102.8 | (248.7)
Net Cash Used for Investing Activities | (2,762.3) | (2,258.9) | (8,082.9)
Cash Flows from Financing Activities |  |  |
Dividends paid | (3,086.8) | (2,687.1) | (2,409.8)
Net change in short-term borrowings | (4.0) | (1,494.2) | 995.4
Proceeds from issuance of long-term debt | 2,410.8 | 2,062.3 | 6,556.4
Repayments of long-term debt | (1,905.4) | (276.5) | (2,866.4)
Purchases of common stock | (1,250.0) | (500.0) | (4,400.0)
Other financing activities, net | (295.9) | (241.6) | (200.1)
Net Cash Used for Financing Activities | (4,131.3) | (3,137.1) | (2,324.5)
Effect of exchange rate changes on cash and cash equivalents | (205.7) | 216.0 | (89.9)
Net increase (decrease) in cash and cash equivalents | 161.4 | 1,319.6 | (5,660.7)
Cash and cash equivalents at beginning of year (2019 includes $677.5 of discontinued operations) | 3,657.1 | 2,337.5 | 7,998.2
Cash and Cash Equivalents at End of Year | $ 3,818.5 | $ 3,657.1 | $ 2,337.5

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