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Goodwill and other intangible assets - Identifiable Intangible Assets (Details) - USD ($)
$ in Millions
Dec. 31, 2020
Dec. 31, 2019
Finite-lived intangible assets:    
Gross carrying amounts $ 32,018 $ 31,991
Accumulated amortization (15,461) (12,632)
Other intangible assets, net 16,557 19,359
Indefinite-lived intangible assets:    
Identifiable intangible assets 32,048 32,045
Accumulated amortization (15,461) (12,632)
Identifiable intangible assets, net 16,587 19,413
IPR&D [Member]    
Indefinite-lived intangible assets:    
Indefinite-lived intangible assets 30 54
Developed Technology Rights    
Finite-lived intangible assets:    
Gross carrying amounts 25,591 25,575
Accumulated amortization (10,564) (8,322)
Other intangible assets, net 15,027 17,253
Licensing rights    
Finite-lived intangible assets:    
Gross carrying amounts 3,743 3,761
Accumulated amortization (2,791) (2,398)
Other intangible assets, net 952 1,363
Marketing-related rights [Member]    
Finite-lived intangible assets:    
Gross carrying amounts 1,367 1,382
Accumulated amortization (1,041) (965)
Other intangible assets, net 326 417
R&D technology rights [Member]    
Finite-lived intangible assets:    
Gross carrying amounts 1,317 1,273
Accumulated amortization (1,065) (947)
Other intangible assets, net $ 252 $ 326