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Stockholders' equity (Reclassifications out of AOCI) (Details) - USD ($) $ in Millions | 3 Months Ended
--- | ---
Mar. 31, 2019 | Mar. 31, 2018
Reclassification out of Accumulated Other Comprehensive Income [Line Items] |  |
Interest and other income, net | $ 185 | $ 231
Income before income taxes | 2,314 | 2,619
Provision for income taxes | (322) | (308)
Net income | 1,992 | 2,311
Product sales [Member] |  |
Reclassification out of Accumulated Other Comprehensive Income [Line Items] |  |
Product sales | 5,286 | 5,343
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 | (28) | 130
Provision for income taxes | 6 | (28)
Net income | (22) | 102
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 | (4) | (134)
Provision for income taxes | 0 | 1
Net income | (4) | (133)
Reclassification out of Accumulated Other Comprehensive Income [Member] | Foreign currency contract [Member] | Cash flow hedges [Member] | Product sales [Member] |  |
Reclassification out of Accumulated Other Comprehensive Income [Line Items] |  |
Product sales | 14 |
Reclassification out of Accumulated Other Comprehensive Income [Member] | Cross-currency swap contract [Member] | Cash flow hedges [Member] |  |
Reclassification out of Accumulated Other Comprehensive Income [Line Items] |  |
Interest and other income, net | (42) |
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 | (28) | 130
Reclassification out of Accumulated Other Comprehensive Income [Member] | Cash flow hedges [Member] | Foreign currency contract [Member] | Cash flow hedges [Member] | Product sales [Member] |  |
Reclassification out of Accumulated Other Comprehensive Income [Line Items] |  |
Product sales | 14 | (34)
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 | $ (42) | $ 164

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