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Derivative instruments (Locations and Effective Portions of Gain (Loss) Reclassified out of AOCI) (Details) - USD ($) $ in Millions | 3 Months Ended | 12 Months Ended
--- | --- | ---
Dec. 31, 2017 | Sep. 30, 2017 | Jun. 30, 2017 | Mar. 31, 2017 | Dec. 31, 2016 | Sep. 30, 2016 | Jun. 30, 2016 | Mar. 31, 2016 | Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015
Derivative Instruments Gain Loss [Line Items] |  |  |  |  |  |  |  |  |  |  |
Product sales | $ 5,569 | $ 5,453 | $ 5,574 | $ 5,199 | $ 5,663 | $ 5,516 | $ 5,474 | $ 5,239 | $ 21,795 | $ 21,892 | $ 20,944
Interest and other income, net |  |  |  |  |  |  |  |  | 928 | 629 | 603
Interest expense, net |  |  |  |  |  |  |  |  | (1,304) | (1,260) | (1,095)
Income before income taxes |  |  |  |  |  |  |  |  | 9,597 | 9,163 | 7,978
Accumulated net gain (loss) from designated or qualifying cash flow hedges [Member] | Reclassification out of AOCI [Member] |  |  |  |  |  |  |  |  |  |  |
Derivative Instruments Gain Loss [Line Items] |  |  |  |  |  |  |  |  |  |  |
Income before income taxes |  |  |  |  |  |  |  |  | 638 | (139) | 143
Accumulated net gain (loss) from designated or qualifying cash flow hedges [Member] | Reclassification out of AOCI [Member] | Derivatives in cash flow hedging relationships [Member] |  |  |  |  |  |  |  |  |  |  |
Derivative Instruments Gain Loss [Line Items] |  |  |  |  |  |  |  |  |  |  |
Income before income taxes |  |  |  |  |  |  |  |  | 638 | (139) | 143
Accumulated net gain (loss) from designated or qualifying cash flow hedges [Member] | Reclassification out of AOCI [Member] | Derivatives in cash flow hedging relationships [Member] | Foreign currency contracts [Member] |  |  |  |  |  |  |  |  |  |  |
Derivative Instruments Gain Loss [Line Items] |  |  |  |  |  |  |  |  |  |  |
Product sales |  |  |  |  |  |  |  |  | 65 | 308 | 326
Accumulated net gain (loss) from designated or qualifying cash flow hedges [Member] | Reclassification out of AOCI [Member] | Derivatives in cash flow hedging relationships [Member] | Cross-currency swap contracts [Member] |  |  |  |  |  |  |  |  |  |  |
Derivative Instruments Gain Loss [Line Items] |  |  |  |  |  |  |  |  |  |  |
Interest and other income, net |  |  |  |  |  |  |  |  | 574 | (446) | (182)
Accumulated net gain (loss) from designated or qualifying cash flow hedges [Member] | Reclassification out of AOCI [Member] | Derivatives in cash flow hedging relationships [Member] | Forward interest rate contract [Member] |  |  |  |  |  |  |  |  |  |  |
Derivative Instruments Gain Loss [Line Items] |  |  |  |  |  |  |  |  |  |  |
Interest expense, net |  |  |  |  |  |  |  |  | $ (1) | $ (1) | $ (1)

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