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Stockholders' equity (Reclassifications out of AOCI) (Details) - USD ($) $ in Millions	3 Months Ended				6 Months Ended
	Jun. 30, 2022	Mar. 31, 2022	Jun. 30, 2021	Mar. 31, 2021	Jun. 30, 2022	Jun. 30, 2021
Reclassification out of Accumulated Other Comprehensive Income [Line Items]
Total revenues	$ 6,594		$ 6,526		$ 12,832	$ 12,427
Other (expense) income, net	(317)		11		(847)	24
Income before income taxes	1,531		558		3,206	2,415
Provision for income taxes	(214)		(94)		(413)	(305)
Net income	1,317	$ 1,476	464	$ 1,646	2,793	2,110
Product sales [Member]
Reclassification out of Accumulated Other Comprehensive Income [Line Items]
Total revenues	6,281		6,114		12,012	11,706
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	(132)		28		(183)	(105)
Provision for income taxes	28		(6)		39	22
Net income	(104)		22		(144)	(83)
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]
Total revenues	53		(18)		80	(19)
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]
Other (expense) income, net	(185)		46		(263)	(86)
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]
Total revenues	53		(18)		80	(19)
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]
Other (expense) income, net	$ (185)		$ 46		$ (263)	$ (86)

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