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Goodwill and intangible assets (Identifiable Intangible Assets) (Details) - USD ($) $ in Millions | Dec. 31, 2018 | Dec. 31, 2017
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Finite-lived intangible assets: |  |
Gross carrying amounts | $ 18,790 | $ 18,344
Accumulated amortization | (11,402) | (10,121)
Other intangible assets, net | 7,388 | 8,223
Indefinite-lived intangible assets: |  |
Identifiable intangible assets | 18,845 | 18,730
Accumulated amortization | (11,402) | (10,121)
Identifiable intangible assets, net | 7,443 | 8,609
IPR&D [Member] |  |
Indefinite-lived intangible assets: |  |
Indefinite-lived intangible assets | 55 | 386
Developed product technology rights [Member] |  |
Finite-lived intangible assets: |  |
Gross carrying amounts | 12,573 | 12,589
Accumulated amortization | (7,479) | (6,796)
Other intangible assets, net | 5,094 | 5,793
Licensing rights [Member] |  |
Finite-lived intangible assets: |  |
Gross carrying amounts | 3,772 | 3,275
Accumulated amortization | (2,032) | (1,601)
Other intangible assets, net | 1,740 | 1,674
Marketing-related rights [Member] |  |
Finite-lived intangible assets: |  |
Gross carrying amounts | 1,297 | 1,319
Accumulated amortization | (1,019) | (920)
Other intangible assets, net | 278 | 399
R&D technology rights [Member] |  |
Finite-lived intangible assets: |  |
Gross carrying amounts | 1,148 | 1,161
Accumulated amortization | (872) | (804)
Other intangible assets, net | $ 276 | $ 357

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