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Consolidated Statements of Cash Flows - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Cash Flows from Operating Activities
Net income	$ 6,244.8	$ 5,581.7	$ 6,193.7
Adjustments to Reconcile Net Income to Cash Flows from Operating Activities:
Depreciation and amortization	1,522.5	1,547.6	1,323.9
Debt extinguishment loss (Note 11)	0.0	405.2	0.0
Change in deferred income taxes	(2,185.2)	(802.3)	(134.5)
Stock-based compensation expense	371.1	342.8	308.1
Net investment (gains) losses	420.0	(178.0)	(1,438.5)
Acquired in-process research and development and development milestones (Note 3)	420.9	874.9	660.4
Other non-cash operating activities, net	304.8	511.4	333.9
Other changes in operating assets and liabilities, net of acquisitions and divestitures:
Receivables—(increase) decrease	(299.6)	(1,278.3)	(1,350.2)
Inventories—(increase) decrease	(599.7)	(235.9)	(533.4)
Other assets—(increase) decrease	(793.5)	1,515.4	(457.1)
Income taxes payable—increase (decrease)	346.6	(359.7)	322.0
Accounts payable and other liabilities—increase (decrease)	1,331.7	(664.1)	1,271.3
Net Cash Provided by Operating Activities	7,084.4	7,260.7	6,499.6
Cash Flows from Investing Activities
Purchases of property and equipment	(1,854.3)	(1,309.8)	(1,387.9)
Proceeds from sales and maturities of short-term investments	121.4	47.4	129.7
Purchases of short-term investments	(107.4)	(83.5)	(11.4)
Proceeds from sales of noncurrent investments	342.2	800.0	757.1
Purchases of noncurrent investments	(600.2)	(929.9)	(358.7)
Purchases of in-process research and development	(629.7)	(563.4)	(641.2)
Cash paid for acquisitions, net of cash acquired (Note 3)	(327.2)	(747.4)	(849.3)
Other investing activities, net	(206.4)	24.3	102.8
Net Cash Used for Investing Activities	(3,261.6)	(2,762.3)	(2,258.9)
Cash Flows from Financing Activities
Dividends paid	(3,535.8)	(3,086.8)	(2,687.1)
Net change in short-term borrowings	1,498.0	(4.0)	(1,494.2)
Proceeds from issuance of long-term debt	0.0	2,410.8	2,062.3
Repayments of long-term debt	(1,560.0)	(1,905.4)	(276.5)
Purchases of common stock	(1,500.0)	(1,250.0)	(500.0)
Other financing activities, net	(308.9)	(295.9)	(241.6)
Net Cash Used for Financing Activities	(5,406.7)	(4,131.3)	(3,137.1)
Effect of exchange rate changes on cash and cash equivalents	(167.6)	(205.7)	216.0
Net increase (decrease) in cash and cash equivalents	(1,751.5)	161.4	1,319.6
Cash and cash equivalents at beginning of year	3,818.5	3,657.1	2,337.5
Cash and Cash Equivalents at End of Year	$ 2,067.0	$ 3,818.5	$ 3,657.1

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