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Stockholders' equity (Reclassifications out of AOCI) (Details) - USD ($) $ in Millions | 3 Months Ended
--- | ---
Mar. 31, 2018 | Mar. 31, 2017
Reclassification out of Accumulated Other Comprehensive Income [Line Items] |  |
Product sales | $ 5,343 | $ 5,199
Interest and other income, net | 231 | 195
Income before income taxes | 2,619 | 2,460
Provision for income taxes | (308) | (389)
Net income | 2,311 | 2,071
Reclassification out of Accumulated Other Comprehensive Income [Member] | Cash flow hedges [Member] |  |
Reclassification out of Accumulated Other Comprehensive Income [Line Items] |  |
Income before income taxes | 130 | 131
Provision for income taxes | (28) | (47)
Net income | 102 | 84
Reclassification out of Accumulated Other Comprehensive Income [Member] | Available-for-sale securities [Member] |  |
Reclassification out of Accumulated Other Comprehensive Income [Line Items] |  |
Interest and other income, net | (134) | (49)
Provision for income taxes | 1 | 0
Net income | (133) | (49)
Reclassification out of Accumulated Other Comprehensive Income [Member] | Cash flow hedges [Member] | Cash flow hedges [Member] |  |
Reclassification out of Accumulated Other Comprehensive Income [Line Items] |  |
Income before income taxes | 130 | 131
Reclassification out of Accumulated Other Comprehensive Income [Member] | Cash flow hedges [Member] | Foreign currency contract [Member] | Cash flow hedges [Member] |  |
Reclassification out of Accumulated Other Comprehensive Income [Line Items] |  |
Product sales | (34) | 57
Reclassification out of Accumulated Other Comprehensive Income [Member] | Cash flow hedges [Member] | Cross-currency swap contract [Member] | Cash flow hedges [Member] |  |
Reclassification out of Accumulated Other Comprehensive Income [Line Items] |  |
Interest and other income, net | $ 164 | $ 74

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