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Acquisitions and divestitures - Narrative (Details) - USD ($)
$ / shares in Units, $ in Millions
 2 Months Ended 12 Months Ended
Oct. 08, 2024
Jul. 11, 2024
Jun. 20, 2024
May 31, 2024
Dec. 22, 2022
Feb. 13, 2025
Dec. 29, 2024
Dec. 31, 2023
Jan. 01, 2023
Business Acquisition [Line Items]                  
Payments to acquire businesses, gross             $ 15,100 $ 17,700  
Acquisitions, net of cash acquired (Note 18)             15,146 0 $ 17,652
Goodwill, related to acquisitions             8,209 0  
Contingent Consideration             1,217 1,092  
Acquisition related costs                 300
Dividends payable, amount per share (in dollars per share)         $ 8.75        
Research and development in process             211 313 783
Intangible assets useful life         14 years        
Proceeds from divestiture of brands               200 0
Asset, held-for-sale, not part of disposal group               300  
Goodwill, measurement period adjustment             200    
Acclarent                  
Business Acquisition [Line Items]                  
Proceeds from divestiture of brands             300    
Ponvory                  
Business Acquisition [Line Items]                  
Proceeds from divestiture of brands             200    
V-Wave Ltd.                  
Business Acquisition [Line Items]                  
Consideration transferred $ 600                
IPR&D charge 500                
Yellow Jersey Therapeutics                  
Business Acquisition [Line Items]                  
Consideration transferred   $ 1,250              
IPR&D charge   $ 1,250              
Laminar                  
Business Acquisition [Line Items]                  
Consideration transferred               400  
IPR&D charge               400  
MedTech                  
Business Acquisition [Line Items]                  
Goodwill, related to acquisitions             7,569 0  
Acquisition related costs             1,000 200  
Acquisition costs, period cost             $ 300 $ 200 300
Maximum | V-Wave Ltd.                  
Business Acquisition [Line Items]                  
Consideration transferred $ 1,100                
Class I Recommendation For Impella                  
Business Acquisition [Line Items]                  
Dividends payable, amount per share (in dollars per share)         $ 10.00        
Intra-Cellular Therapies, Inc. | Forecast                  
Business Acquisition [Line Items]                  
Acquisition price (in dollars per share)           $ 132.00      
Equity interests issued and issuable           $ 14,600      
Ambrx                  
Business Acquisition [Line Items]                  
Acquisition price (in dollars per share)             $ 28.00    
Equity interests issued and issuable             $ 2,000    
Acquisitions, net of cash acquired (Note 18)             1,800    
Other assets assumed             2,300    
Intangible assets assumed             1,900    
Goodwill, related to acquisitions             300    
Total liabilities assumed             $ 500    
Discount rate             17.00%    
Deferred taxes             $ 400    
Ambrx | Minimum                  
Business Acquisition [Line Items]                  
Probability of success factor             40.00%    
Ambrx | Maximum                  
Business Acquisition [Line Items]                  
Probability of success factor             70.00%    
Abiomed                  
Business Acquisition [Line Items]                  
Acquisition price (in dollars per share)         $ 380.00        
Equity interests issued and issuable         $ 17,100        
Other assets assumed             $ 20,100    
Goodwill, related to acquisitions             11,100    
Total liabilities assumed             3,000    
Contingent Consideration             700   $ 704
Discount rate         9.50%        
Cash and equivalents         $ 16,500        
Dividends payable, amount per share (in dollars per share)         $ 17.50        
Cash acquired from acquisition             300    
Finite-lived intangible assets acquired             6,600    
Research and development in process             1,100    
Marketable securities assumed             600    
Deferred taxes             2,000    
Abiomed | Minimum                  
Business Acquisition [Line Items]                  
Probability of success factor         52.00%        
Abiomed | Maximum                  
Business Acquisition [Line Items]                  
Probability of success factor         70.00%        
Abiomed | Impella                  
Business Acquisition [Line Items]                  
Dividends payable, amount per share (in dollars per share)         $ 7.50        
Abiomed | Non-Tradeable Contingent Value Right                  
Business Acquisition [Line Items]                  
Non-tradeable contingent value right (in dollars per share)         $ 35.00        
Non-tradeable contingent value right         $ 1,600        
Contingent consideration         $ 3,700        
Proteologix                  
Business Acquisition [Line Items]                  
Acquisitions, net of cash acquired (Note 18)     $ 800            
Other assets assumed     1,200            
Intangible assets assumed     900            
Goodwill, related to acquisitions     300            
Total liabilities assumed     300            
Contingent Consideration     $ 100       105    
Discount rate     16.00%            
Acquisition related costs             0    
Proteologix | Minimum                  
Business Acquisition [Line Items]                  
Probability of success factor     30.00%            
Proteologix | Maximum                  
Business Acquisition [Line Items]                  
Probability of success factor     45.00%            
Shockwave Medical, Inc.                  
Business Acquisition [Line Items]                  
Acquisition price (in dollars per share)       $ 335.00          
Equity interests issued and issuable       $ 200          
Other assets assumed       15,500     15,500    
Intangible assets assumed       600     600    
Total liabilities assumed       $ 2,900     2,900    
Discount rate       9.00%          
Acquisition related costs             900    
Equity interest in acquiree, remeasurement loss             400    
Equity awards             500    
Weighted average useful life       14 years          
Cash and equivalents       $ 1,100     1,100    
Deferred taxes       $ 1,500     $ 1,500    
Shockwave Medical, Inc. | Minimum                  
Business Acquisition [Line Items]                  
Probability of success factor       50.00%