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Major customers (Customer Concentration, Product Sales) (Details) - Product sales [Member] - USD ($) $ in Millions | 3 Months Ended | 12 Months Ended
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Dec. 31, 2018 | Sep. 30, 2018 | Jun. 30, 2018 | Mar. 31, 2018 | Dec. 31, 2017 | Sep. 30, 2017 | Jun. 30, 2017 | Mar. 31, 2017 | Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016
Revenue, Major Customer [Line Items] |  |  |  |  |  |  |  |  |  |  |
Product sales | $ 6,001 | $ 5,510 | $ 5,679 | $ 5,343 | $ 5,569 | $ 5,453 | $ 5,574 | $ 5,199 | $ 22,533 | $ 21,795 | $ 21,892
AmerisourceBergen Corporation [Member] |  |  |  |  |  |  |  |  |  |  |
Revenue, Major Customer [Line Items] |  |  |  |  |  |  |  |  |  |  |
Product sales |  |  |  |  |  |  |  |  | $ 12,091 | $ 10,742 | $ 10,100
Gross product sales to major customer (as defined) as a percentage of total gross revenues |  |  |  |  |  |  |  |  | 33.00% | 31.00% | 31.00%
Gross product sales to major customer (as defined) as a percentage of U.S. gross product sales |  |  |  |  |  |  |  |  | 39.00% | 37.00% | 38.00%
McKesson Corporation [Member] |  |  |  |  |  |  |  |  |  |  |
Revenue, Major Customer [Line Items] |  |  |  |  |  |  |  |  |  |  |
Product sales |  |  |  |  |  |  |  |  | $ 11,434 | $ 10,625 | $ 9,710
Gross product sales to major customer (as defined) as a percentage of total gross revenues |  |  |  |  |  |  |  |  | 31.00% | 30.00% | 30.00%
Gross product sales to major customer (as defined) as a percentage of U.S. gross product sales |  |  |  |  |  |  |  |  | 35.00% | 35.00% | 34.00%
Cardinal Health, Inc. [Member] |  |  |  |  |  |  |  |  |  |  |
Revenue, Major Customer [Line Items] |  |  |  |  |  |  |  |  |  |  |
Product sales |  |  |  |  |  |  |  |  | $ 7,475 | $ 7,049 | $ 6,520
Gross product sales to major customer (as defined) as a percentage of total gross revenues |  |  |  |  |  |  |  |  | 20.00% | 20.00% | 20.00%
Gross product sales to major customer (as defined) as a percentage of U.S. gross product sales |  |  |  |  |  |  |  |  | 24.00% | 24.00% | 24.00%

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- Definition Amount, including tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value-added and excise. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 606 -SubTopic 10 -Section 50 -Paragraph 1 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=109196051&loc=SL49130539-203045 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 606 -SubTopic 10 -Section 50 -Paragraph 5 -URI http://asc.fasb.org/extlink&oid=109196051&loc=SL49130545-203045 Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 606 -SubTopic 10 -Section 50 -Paragraph 4 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=109196051&loc=SL49130543-203045 + Details
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