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Goodwill and other intangible assets (Identifiable Intangible Assets) (Details) - USD ($) $ in Millions | Sep. 30, 2021 | Dec. 31, 2020
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Finite-Lived Intangible Assets [Line Items] |  |
Gross carrying amounts | $ 32,001 | $ 32,018
Accumulated amortization | (17,372) | (15,461)
Other intangible assets, net | 14,629 | 16,557
Gross carrying amount | 32,031 | 32,048
Accumulated amortization | (17,372) | (15,461)
Intangible assets, net | 14,659 | 16,587
In-process Research and Development [Member] |  |
Indefinite-lived Intangible Assets [Line Items] |  |
Indefinite-lived intangible assets | 30 | 30
Developed-Product-Technology Rights [Member] |  |
Finite-Lived Intangible Assets [Line Items] |  |
Gross carrying amounts | 25,575 | 25,591
Accumulated amortization | (12,222) | (10,564)
Other intangible assets, net | 13,353 | 15,027
Licensing Rights [Member] |  |
Finite-Lived Intangible Assets [Line Items] |  |
Gross carrying amounts | 3,766 | 3,743
Accumulated amortization | (2,931) | (2,791)
Other intangible assets, net | 835 | 952
Marketing-Related Rights [Member] |  |
Finite-Lived Intangible Assets [Line Items] |  |
Gross carrying amounts | 1,362 | 1,367
Accumulated amortization | (1,099) | (1,041)
Other intangible assets, net | 263 | 326
Research and Development Technology Rights [Member] |  |
Finite-Lived Intangible Assets [Line Items] |  |
Gross carrying amounts | 1,298 | 1,317
Accumulated amortization | (1,120) | (1,065)
Other intangible assets, net | $ 178 | $ 252

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