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Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)
$ in Millions
 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Statement of Cash Flows [Abstract]    
Net earnings $ 2,418 $ 4,309
Adjustments to reconcile net earnings to net cash from operating activities:    
Depreciation 559 558
Amortization of intangible assets 5,593 5,726
Deferred income taxes (107) (682)
Change in fair value of contingent consideration liabilities 5,089 3,492
Payments of contingent consideration liabilities (2,184) (1,456)
Stock-based compensation 798 747
Acquired IPR&D and milestones 3,751 1,183
Non-cash litigation reserve adjustments, net of cash payments (1,069) 341
Impairment of Intangible Assets (Excluding Goodwill) 847 0
Other, net 6 (75)
Changes in operating assets and liabilities, net of acquisitions:    
Accounts receivable (1,652) (180)
Inventories (209) (191)
Prepaid expenses and other assets (169) 461
Accounts payable and other liabilities 1,549 (1,070)
Income tax assets and liabilities, net (1,408) (1,405)
Cash flows from operating activities 13,812 11,758
Cash flows from investing activities    
Payments to Acquire Businesses, Net of Cash Acquired (204) (17,493)
Other acquisitions and investments, net of cash acquired (4,076) (1,232)
Acquisitions of property and equipment (885) (683)
Purchases of investment securities (29) (46)
Sales and maturities of investment securities 42 516
Other, net (28) (8)
Cash flows from investing activities (5,180) (18,946)
Cash flows from financing activities    
Net change in commercial paper borrowings with original maturities of three months or less 999 0
Proceeds from issuance of other short-term borrowings 4,798 5,008
Repayments of other short-term borrowings (2,007) (5,008)
Proceeds from issuance of long-term debt 3,994 14,963
Repayments of long-term debt and finance lease obligations (6,789) (3,851)
Debt issuance costs (23) (99)
Dividends paid (8,746) (8,273)
Purchases of treasury stock (977) (1,350)
Proceeds from the exercise of stock options 124 204
Other, net 69 56
Cash flows from financing activities (8,558) 1,650
Effect of exchange rate changes on cash and equivalents 31 (19)
Net change in cash and equivalents 105 (5,557)
Cash and equivalents, beginning of period 5,524 12,814
Cash and equivalents, end of period $ 5,629 $ 7,257