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Goodwill and other intangible assets (Identifiable Intangible Assets) (Details) - USD ($)
$ in Millions
Sep. 30, 2019
Dec. 31, 2018
Finite-Lived Intangible Assets [Line Items]    
Gross carrying amounts $ 18,784 $ 18,790
Accumulated amortization (12,158) (11,402)
Other intangible assets, net 6,626 7,388
Gross carrying amount 18,860 18,845
Accumulated amortization (12,158) (11,402)
Intangible assets, net 6,702 7,443
In-process Research and Development    
Indefinite-lived Intangible Assets [Line Items]    
Indefinite-lived intangible assets 76 55
Developed-Product-Technology Rights [Member]    
Finite-Lived Intangible Assets [Line Items]    
Gross carrying amounts 12,548 12,573
Accumulated amortization (7,978) (7,479)
Other intangible assets, net 4,570 5,094
Licensing Rights [Member]    
Finite-Lived Intangible Assets [Line Items]    
Gross carrying amounts 3,761 3,772
Accumulated amortization (2,286) (2,032)
Other intangible assets, net 1,475 1,740
Marketing-Related Rights [Member]    
Finite-Lived Intangible Assets [Line Items]    
Gross carrying amounts 1,209 1,297
Accumulated amortization (972) (1,019)
Other intangible assets, net 237 278
Research and Development Technology Rights [Member]    
Finite-Lived Intangible Assets [Line Items]    
Gross carrying amounts 1,266 1,148
Accumulated amortization (922) (872)
Other intangible assets, net $ 344 $ 276