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Consolidated Statements of Operations - USD ($)
shares in Thousands, $ in Millions
 12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Income Statement [Abstract]      
Revenue (Note 2) $ 28,541.4 $ 28,318.4 $ 24,539.8
Costs, expenses, and other:      
Cost of sales 6,629.8 7,312.8 5,483.3
Research and development 7,190.8 6,930.7 5,976.3
Marketing, selling, and administrative 6,440.4 6,431.6 6,121.2
Acquired in-process research and development and development milestones (Note 3) 908.5 970.1 769.8
Asset impairment, restructuring, and other special charges (Note 5) 244.6 316.1 131.2
Other—net, (income) expense (Note 18) 320.9 201.6 (1,171.9)
Costs, expenses, and other 21,735.0 22,162.9 17,309.9
Income before income taxes 6,806.4 6,155.5 7,229.9
Income taxes (Note 14) 561.6 573.8 1,036.2
Net income $ 6,244.8 $ 5,581.7 $ 6,193.7
Earnings per share:      
Basic (in dollars per share) $ 6.93 $ 6.15 $ 6.82
Diluted (in dollars per share) $ 6.90 $ 6.12 $ 6.79
Shares used in calculation of earnings per share:      
Basic (in shares) 901,736 906,963 907,634
Diluted (in shares) 904,619 911,681 912,505