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Goodwill and intangible assets (Details Textual) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2018
Dec. 31, 2017
Dec. 31, 2016
Finite-Lived Intangible Assets, Net, Amortization Expense, Fiscal Year Maturity [Abstract]      
Amortization charges associated with finite-lived intangible assets $ 1,300 $ 1,300 $ 1,500
Total estimated amortization of finite-lived intangible assets for 2019 1,300    
Total estimated amortization of finite-lived intangible assets for 2020 1,200    
Total estimated amortization of finite-lived intangible assets for 2021 1,000    
Total estimated amortization of finite-lived intangible assets for 2022 900    
Total estimated amortization of finite-lived intangible assets for 2023 900    
Other operating income (expense) [Member] | IPR&D [Member] | AMG 899 [Member]      
Finite-Lived Intangible Assets [Line Items]      
IPR&D impairment charge $ 330 $ 400