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Stockholders' equity (Reclassifications out of AOCI) (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2021
Dec. 31, 2020
Dec. 31, 2019
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]      
Revenues $ 25,979 $ 25,424 $ 23,362
Other income, net 259 256 753
Interest expense, net (1,197) (1,262) (1,289)
Income before income taxes 6,701 8,133 9,138
Provision for income taxes (808) (869) (1,296)
Net income 5,893 7,264 7,842
Product sales      
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]      
Revenues 24,297 24,240 22,204
Reclassification out of AOCI [Member] | Cash flow hedges [Member]      
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]      
Income before income taxes (253) 501 211
Provision for income taxes 55 (110) (46)
Net income (198) 391 165
Reclassification out of AOCI [Member] | Available-for-sale securities [Member]      
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]      
Other income, net 0 33 56
Provision for income taxes 0 (7) (14)
Net income 0 26 42
Reclassification out of AOCI [Member] | Foreign currency contract [Member] | Product sales | Cash flow hedges [Member]      
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]      
Revenues (8) 178 101
Reclassification out of AOCI [Member] | Cross-currency swap contract [Member] | Cash flow hedges [Member]      
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]      
Other income, net $ (245) $ 323 $ 110